Evaluation and treatment of recurrent spasticity after recurrent laryngeal nerve section. A preliminary report.

Of 365 spastic dysphonia patients treated by recurrent laryngeal nerve (RLN) section to date, 44 (12%) have experienced recurrence of the spastic dysphonia. Most of these 44 patients had moderately severe to very severe spastic dysphonia before the RLN section was performed. We believe, therefore, that preoperative severity is an important predictor of the likelihood of recurrence. Twenty-eight patients with recurrent spastic dysphonia following RLN section were further treated by one or more carbon dioxide laser thinnings of the paralyzed vocal fold. Following this procedure, 23 patients (50%) achieved eradication of spasticity, while a mild degree of spasticity remained in 17 (39%). These findings lead us to conclude that even though spastic dysphonia may recur following RLN section, a viable secondary surgical procedure is available.