Autologous replacement of the vocal fold: a new surgical approach for adduction-type spasmodic dysphonia.
Many surgical approaches have been developed for the treatment of adduction-type spasmodic dysphonia (SPD). We developed and performed a new type of surgical approach (autologous replacement of the vocal fold). Our new surgical technique increases the advantages and decreases the disadvantages of previous surgical procedures in three ways: (1) It has similar effects to the previous procedures in that it prevents contraction of the thyroarytenoid muscle. (2) It decreases vocal-fold tension, as in framework surgery. (3) It reduces glottal incompetence, as does fibrinogen-glue injection, but it is more suitable because it is autologous. Furthermore, it produces increases in the mass and volume of the vocal-fold body and is also safe because the replacement tissue is autologous. The short-term results appear encouraging in preventing spastic voice while also avoiding vocal-fold atrophy. Long-term follow up will be necessary to determine the actual efficacy. However, this is clearly a possible choice as a surgical approach for treating adduction-type SPD.
Tsunoda
Koichi
K
Department of Artificial Organs, National Institute of Sensory Organs, Tokyo, Japan. tsunodakoichi@kankakuki.go.jp
Amagai
Naomi
N
Kondou
Kenji
K
Baer
Tom
T
Kaga
Kimitaka
K
Niimi
Seiji
S
D005205:Fascia / Q000637:transplantation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010699:Phonation; D016896:Treatment Outcome; D014827:Vocal Cords / Q000601:surgery*; D014832:Voice Disorders / Q000601:surgery*