title: Selective denervation: reinnervation for the control of adductor spasmodic dysphonia.
abstract: OBJECTIVE
  The objective of this study was to evaluate the efficacy of a new surgical procedure for adductor spasmodic dysphonia (AddSD). This surgery involves the bilateral selective division of the adductor branches of the recurrent laryngeal nerves with immediate reinnervation of the distal nerve trunks with branches of the ansa cervicalis (selective denervation-reinnervation).
  
  
  METHODS
  Our first six patients to undergo this procedure were enrolled in the study. All patients suffered from AddSD and had previously received botulinum toxin A (Botox, Allergen, Markham, ON) therapy. Patients were recorded preoperatively and all underwent the same surgical procedure performed by the same lead surgeon. All patients were surveyed postoperatively and then re-recorded. Expert and untrained judges undertook perceptual evaluation of voice quality. Voice samples were also objectively evaluated for aphonic voice breaks.
  
  
  RESULTS
  No major surgical complications were noted. Patient satisfaction was excellent, and five of the six patients no longer require botulinum toxin therapy. In five of the six patients, the majority of untrained and expert listeners perceived the postoperative voice to be superior. Objectively, the rate of aphonic voice breaks was also reduced in five of the six patients.
authors.affiliation: Department of Surgery (Otolaryngology), University of Alberta, Edmonton, AB.
authors.forename: Michael
authors.initials: M
authors.lastname: Allegretto
authors.forename: Murray
authors.initials: M
authors.lastname: Morrison
authors.forename: Linda
authors.initials: L
authors.lastname: Rammage
authors.forename: David P
authors.initials: DP
authors.lastname: Lau
mesh_terms: D002572:Cervical Plexus / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D017764:Parasympathectomy / Q000379:methods*; D017060:Patient Satisfaction; D020127:Recovery of Function / Q000502:physiology; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology* / Q000601:surgery*; D014832:Voice Disorders / Q000601:surgery*