title: Functional reinnervation of vocal folds after selective laryngeal adductor denervation-reinnervation surgery for spasmodic dysphonia.
abstract: Selective laryngeal adductor denervation-reinnervation surgery (SLAD-R) offers a viable surgical alternative for patients with adductor spasmodic dysphonia refractory to botulinum toxin injections. SLAD-R selectively denervates the symptomatic thyroarytenoid muscle by dividing the distal adductor branch of the recurrent laryngeal nerve (RLN), and preventing reinnervation, by the proximal RLN and maintaining vocal fold bulk and tone by reinnervating the distal RLN with the ansa cervicalis. We present a patient who had previously undergone successful SLAD-R but presented 10 years postoperatively with a new regional dystonia involving his strap muscles translocated to his reinnervated larynx by his previous ansa-RLN neurorraphy. The patient's symptomatic vocal fold adduction resolved completely on division of the ansa-RLN neurorraphy confirming successful selective functional reinnervation of vocal fold adductors by the ansa cervicalis.
authors.affiliation: Division of Head and Neck Surgery, University of California, Los Angeles, California 90095-1624, USA. adeconde@mednet.ucla.edu
authors.forename: Adam S
authors.initials: AS
authors.lastname: DeConde
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Long
authors.forename: Bob B
authors.initials: BB
authors.lastname: Armin
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Berke
mesh_terms: D000328:Adult; D055154:Dysphonia / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007821:Laryngeal Muscles / Q000294:innervation*; D008297:Male; D009121:Muscle Denervation / Q000379:methods*; D012008:Recurrence; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome; D014827:Vocal Cords / Q000294:innervation*; D014833:Voice Quality