Spastic dysphonia, characterized by a strained, choked voice with aphonic breaks and extreme tension of the phonatory system, has long been resistant to various forms of therapy. Traditional approaches, including psychotherapy and speech therapy, have shown limited success. However, a new surgical treatment proposed by Dr. Herbert Dedo has demonstrated promising results, as detailed in the research article "A New Approach to Treatment of Spastic Dysphonia" by Nomi Kaston and E.L. Attla from the Montreal General Hospital.
Case Report: A Successful Surgical Intervention
The article presents a case of a 45-year-old male with a ten-year history of spastic dysphonia. Despite numerous attempts with hypnosis, speech therapy, acupuncture, and psychotherapy, the patient experienced no significant improvement. His condition was marked by strained and choked voice with frequent aphonic moments, lip tremors, facial grimaces, and flushing.
In May 1976, after learning about Dedo's experimental surgical treatment, the patient underwent a trial procedure where Xylocaine was injected into his left recurrent laryngeal nerve, temporarily paralyzing one vocal cord. The result was a soft, breathy voice free of spasms. Encouraged by this outcome, the patient opted for permanent surgical sectioning of the recurrent laryngeal nerve.
Post-surgery, the patient immediately exhibited a voice free of spasms, although slightly breathy. Over time, with the aid of speech therapy, he achieved a louder, clearer voice. This case supports the efficacy of Dedo's surgical approach, providing a potential solution for patients suffering from this debilitating condition.
Implications for Practitioners
For practitioners, this research offers several key takeaways:
- Consider Surgical Options: For patients with spastic dysphonia who have not responded to traditional therapies, surgical intervention may be a viable option.
- Collaborate with Otolaryngologists: Effective treatment may require a multidisciplinary approach, including collaboration with otolaryngologists to assess the suitability of surgical options.
- Post-Operative Speech Therapy: Post-surgical speech therapy is crucial in helping patients optimize their voice quality and volume. Techniques such as pushing exercises can help improve vocal cord approximation and reduce breathiness.
- Further Research: Encourage further research into the etiology and treatment of spastic dysphonia. Understanding the underlying causes can help refine treatment approaches and improve patient outcomes.
Conclusion
The case study presented in the research article highlights the potential of surgical intervention in treating spastic dysphonia. By considering surgical options and emphasizing post-operative speech therapy, practitioners can significantly improve the quality of life for their patients. To stay updated on the latest advancements, practitioners are encouraged to engage in ongoing research and professional development.
To read the original research paper, please follow this link: A New Approach to Treatment of Spastic Dysphonia
