著者

一色 信彦 山本 ゆき子 前田 秀夫

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.92, no.1, pp.81-87, 1999-01-01 (Released:2011-11-04)

参考文献数

16

被引用文献数

1 4

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A 40 year-old woman with adductor spasmodic dysphonia was successfully treated with type 2 thyroplasty, that aimed at lateralization of the vocal folds. Her voice had been characteristic of spasmodic dysphonia; strained, constricted and requiring effort. She had not responded to voice therapy.Under local anesthesia, the thyroid cartilage was incised at the midline and the incised edges were pulled apart to lateralize the vocal folds. A perforation was created at the anterior commissure to enhance the lateralization. The hole was closed with a free composite graft, and the incised thyroid alae were kept 4mm apart with silicone shims. A part of the sternohyoid muscle was shifted medially to cover the free graft for better survival and to block the space between the graft and the silicone shim to prevent infection.The postoperative course was uneventful, and the voice has been restored to normal, without any sign of recurrence as of 1 year postoperatively.The advantages of the technique include: 1. node privation of the physiological functions; 2. less likelihood of recurrence because no nerve regrowth is involved; and 3. revisionis simple in the unlikely event of recurrence (the silicone shimis replaced with a wider one).