As a practitioner in the field of speech therapy, staying updated with the latest research and treatment methodologies is crucial. One such groundbreaking study is "A New Approach to Treatment of Spastic Dysphonia" by Noml Kaston and E.L. Attla, which explores a surgical intervention for a condition often deemed resistant to traditional therapies.
Spastic dysphonia, characterized by a strained, choked voice with aphonic breaks and extreme tension of the phonatory system, has historically been resistant to various forms of therapy. Traditional methods, including psychotherapy and speech therapy, have shown limited success. However, recent advancements have introduced a surgical approach that offers hope to those affected by this debilitating condition.
Understanding the New Surgical Approach
The research conducted by Kaston and Attla describes a case of successful treatment of spastic dysphonia through surgical sectioning of one recurrent laryngeal nerve, leading to paralysis of one vocal cord in a paramedian position. This procedure, initially suggested by Dr. Herbert Dedo, resulted in complete elimination of spastic dysphonia in the reported case.
In the study, a 45-year-old male patient with a decade-long history of dysphonia underwent the surgical procedure after various non-surgical treatments, including hypnosis, speech therapy, acupuncture, and psychotherapy, failed to yield significant improvement. The surgical intervention involved the following steps:
- An incision was made along the anterior border of the left sternocleidomastoid.
- The underlying muscles were retracted, and the recurrent laryngeal nerve was identified.
- An eight-millimeter section of the nerve was removed, resulting in paralysis of the left vocal cord in a paramedian position.
Post-surgery, the patient experienced immediate relief from the symptoms of spastic dysphonia. His voice was free of spasms, and although slightly breathy, it was significantly improved. Further speech therapy helped the patient achieve a clearer and louder voice, with no recurrence of spastic dysphonia symptoms.
Implications for Practitioners
This research offers several key takeaways for practitioners looking to enhance their treatment strategies for spastic dysphonia:
- Consider Surgical Options: While traditional therapies may offer limited success, surgical intervention can provide significant and lasting relief for patients with spastic dysphonia.
- Pre- and Post-Operative Therapy: Voice therapy remains essential both before and after the surgical procedure to maximize vocal function and patient satisfaction.
- Holistic Patient Assessment: Comprehensive evaluation, including psychological and neurological assessments, is crucial to determine the most effective treatment approach.
- Continued Research: Further research is necessary to explore the etiology of spastic dysphonia and refine surgical techniques for even better outcomes.
By integrating these insights into your practice, you can offer more effective and comprehensive care to patients suffering from spastic dysphonia. Encouraging further research in this area will also contribute to the development of more refined and successful treatment methodologies.
To read the original research paper, please follow this link: A New Approach to Treatment of Spastic Dysphonia.
