Intermediate results of 306 recurrent laryngeal nerve sections for spastic dysphonia

Recurrent laryngeal nerve section for spastic dysphonia was first performed in 1975 because prior forms of treatment had failed. Virtually every patient has had a detailed postoperative follow-up which includes a tape recording and a self-assessment questionnaire. The majority of patients remain free of spasticity at this medium-term follow-up. In some, spasticity recurred with less than preoperative severity. A small percentage of patients have a persistent breathy phonation. The first group is treated with vocal fold lateralization procedure using the CO2 laser; the second, with Teflon. When needed, voice therapy is also given. This paper provides a basis for diagnosis, indications for surgery, primary and secondary surgical techniques, encountered problems, and medium-term follow-up results.