Surgery to treat vocal-cord spasms shows high success rate

The first large, long-term study of patients who had surgery to control vocal-cord spasms showed excellent results in the majority of cases, reports new UCLA research presented May 14 at the 126th Annual Meeting of the American Laryngological Association.

"We are very encouraged by our results," said Dr. Dinesh Chhetri, assistant professor of head and neck surgery at the David Geffen School of Medicine at UCLA, who presented the findings. "When spasmodic dysphonia symptoms do not return within one year, they generally will not be coming back. Our findings suggest that this surgical technique provides the first permanent solution to treating the condition."

Spasmodic dysphonia is a neurological condition that disrupts nervous signals to the vocal cords, preventing them from vibrating properly. The voice is reduced to a strangled, broken whisper, interfering with a person's ability to communicate and enjoy a successful career and personal life. The disorder affects 50,000 people in the United States, and its cause remains unknown.

In 1989, the FDA approved the use of Botox injections into the vocal cords. Required every few months, these treatments temporarily relieve the symptoms, but not the disorder. At up to $2,000 a pop, the shots are pricey as well as uncomfortable and time-consuming. Some patients also can develop Botox resistance.

In 1993, Dr. Gerald Berke, chief of head and neck surgery at the David Geffen School of Medicine at UCLA, pioneered the first surgery to permanently treat spasmodic dysphonia symptoms. The surgeon severs the nerve sending abnormal signals to the vocal cords, and then attaches a healthy nerve from the throat to maintain the vocal cords' muscle tone.

Chhetri and his colleagues surveyed 131 patients at an average of four years post-surgery. Eighty-one patients completed the questionnaire. Of these patients, 91 percent expressed greater satisfaction with their vocal quality post-surger

Contact: Elaine Schmidt
University of California - Los Angeles

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