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Transoral radiofrequency of the terminal branches of the recurrent nerve in the treatment of adductor spasmodic dysphonia: our experience over 11 patients

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Spasmodic dysphonia (SD) or laryngeal dystonia is as a rare vocal disorder characterized by involuntary action-induced endolaryngeal contraction. In the last decade, botulin toxin injection has become the standard treatment in adductor spasmodic dysphonia necessitating repetitive injections. The purpose of this study is to analyze retrospectively data from patients treated with the minimal-invasive transoral radiofrequency-induced thermotherapy (RFITT) of the terminal branches of the recurrent nerve.

Methods

Between 2009 and 2015, 11 patients (six females and five males aged from 32 to 91 years) with adductor SD were treated with RFITT. Pre-operative and post-operative vocal assessments (VHI-30, GRBASI, and acoustic-aerodynamics measurements), number of surgical revisions, delay between procedures, and post-operative complications were recorded. Statistical analyses were carried out on the first vocal assessment performed 2–8 weeks after the first procedure.

Results

Based on available data from ten patients, voice handicap index (VHI) showed improvement with a mean value of −17.7 points (p-value (pval) = 0.014, adjusted p-value (adj pval) = 0.21); instability has also revealed improvement in six patients (pval = 0.05, adj pval = 0.31). Four patients underwent only one procedure including one patient showing still long-term beneficial results after 5 years of follow-up. Other patients required one to three new procedures with an average time between procedures of 15.3 months. Over 24 surgeries performed on a total of 11 patients, one definitive treatment-related severe adverse event was reported.

Conclusion

Thanks to long-lasting effect, repetitive treatments are less frequent compared to botulin toxin therapy. In our opinion, RFITT is a promising alternative to botulin toxin as a second-step procedure in case of toxin resistance or patient’s lack of compliance.

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References

  1. Hintze JM, Ludlow CL, Bansberg SF, Adler CH, Lott DG (2017) Spasmodic dysphonia: a review. Part 1: pathogenic factors. Otolaryngol Head Neck Surg 157(4):551–557

    Article  Google Scholar 

  2. Blitzer A, Brin MF, Stewart CF (1998) Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients. Laryngoscope 108(10):1435–1441

    Article  CAS  Google Scholar 

  3. van Esch BF, Wegner I, Stegeman I, Grolman W (2017) Effect of botulinum toxin and surgery among spasmodic dysphonia patients. Otolaryngol Head Neck Surg 156(2):238–254

    Article  Google Scholar 

  4. Watts CC, Whurr R, Nye C (2004) Botulinum toxin injections for the treatment of spasmodic dysphonia. Cochrane Database Syst Rev (3):CD004327

  5. Schuering JHC, Heijnen BJ, Sjögren EV, Langeveld APM (2020) Adductor spasmodic dysphonia: botulinum toxin a injections or laser thyro-arytenoid myoneurectomy? A comparison from the patient perspective. Laryngoscope 130(3):741–746

    Article  CAS  Google Scholar 

  6. Mendelsohn AH, Berke GS (2012) Surgery or botulinum toxin for adductor spasmodic dysphonia: a comparative study. Ann Otol Rhinol Laryngol 121(4):231–238

    Article  Google Scholar 

  7. Shoffel-Havakuk H, Rosow DE, Lava CX, Hapner ER, Johns MM 3rd (2019) Common practices in botulinum toxin injection for spasmodic dysphonia treatment: a national survey. Laryngoscope 129(7):1650–1656

    Article  Google Scholar 

  8. Park JB, Simpson LL, Anderson TD, Sataloff R (2003) Immunologic characterization of spasmodic dysphonia patients who develop resistance to botulinum toxin. J Voice 17(2):255–264

    Article  Google Scholar 

  9. Remacle M, Plouin-Gaudon I, Lawson G, Abitbol J (2005) Bipolar radiofrequency-induced thermotherapy (rfitt) for the treatment of spasmodic dysphonia. A report of three cases. Eur Arch Otorhinolaryngol 262(10):871–874

    Article  Google Scholar 

  10. Woisard V, Bodin S, Puech M (2004) Le “Voice Handicap Index”: impact de la traduction française sur la validation [The Voice Handicap Index: impact of the translation in French on the validation]. Rev Laryngol Otol Rhinol (Bord) 125(5):307–312

    CAS  Google Scholar 

  11. Whurr R, Lorch M (2016) Review of differential diagnosis and management of spasmodic dysphonia. Curr Opin Otolaryngol Head Neck Surg 24(3):203–207

    Article  Google Scholar 

  12. Paniello RC, Barlow J, Serna JS (2008) Longitudinal follow-up of adductor spasmodic dysphonia patients after botulinum toxin injection: quality of life results. Laryngoscope 118(3):564–568

    Article  Google Scholar 

  13. Kim HS, Choi HS, Lim JY et al (2008) Radiofrequency thyroarytenid myothermy for treatment of adductor spasmodic dysphonia: How we do? Clin Otolaryngol 33:607–628

    Article  Google Scholar 

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Funding

No funding was received for conducting this study.

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Author notes

  1. S. Beyaert and G. Delahaut contributed equally to this work.

Authors and Affiliations

  1. Department of ENT and Head and Neck Surgery, Université catholique de Louvain, CHU UCL Namur, Avenue du Dr Gaston Therasse 1, 5530, Yvoir, Belgium

    S. Beyaert, G. Delahaut, G. Lawson, V. Bachy, S. Hassid, L. Delacroix & S. Van der Vorst

  2. Institut de Recherche Expérimentale et Clinique (IREC), Centre de Technologies Moléculaires Appliquées, Université Catholique de Louvain, Brussels, Belgium

    J. Ambroise

  3. Department of ENT and Head and Neck Surgery, Centre Hospitalier Luxembourg, Luxembourg, Luxembourg

    M. Remacle

Authors
  1. S. Beyaert
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  2. G. Delahaut
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  3. J. Ambroise
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  4. G. Lawson
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  5. V. Bachy
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  6. S. Hassid
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  7. L. Delacroix
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  8. M. Remacle
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  9. S. Van der Vorst
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Contributions

Conceptualization: [GD]; methodology: [GD, SB, and JA]; formal analysis and investigation: [GD, SB, and JA]; materials: [GL, VB, MR, SVdV, LD, and SH]; writing—original draft preparation: [SB] writing—review and editing: [GD and SVdV], and Supervision: [SVdV]. One participating author is member of the editorial board of the present journal.

Corresponding author

Correspondence to G. Delahaut.

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Conflict of interest

The authors have no relevant financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of CHU UCL Namur, site Godinne (76/2020).

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Beyaert, S., Delahaut, G., Ambroise, J. et al. Transoral radiofrequency of the terminal branches of the recurrent nerve in the treatment of adductor spasmodic dysphonia: our experience over 11 patients. Eur Arch Otorhinolaryngol 279, 4465–4472 (2022). https://doi.org/10.1007/s00405-022-07409-4

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  • DOI: https://doi.org/10.1007/s00405-022-07409-4

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