Selective Laryngeal Deinnervation and Reinnveration

Deinnervation-reinnervation is a surgery used to treated spasmodic dypshonia. Spasmodic dypshonia is a disorder in which a patient has laryngeal spasms which cause spastic or strangled speech. While botox injections are most commmonly used for management of spasmodic dysphonia symptoms, de-innervation reinnervation has been shown to treat this disorder.

The voice box, or larynx, is controlled by branches of the recurrent laryngeal nerve. This nerve branches to innervate, or power, specific muscles of the larynx.

Deinnervation-reinnervation surgery involves “de-innervating” or cutting the nerves that power the muscles which are spastic in spasmodic dysphonia.

Through a cut on the neck a portion of the thyroid cartilage is removed to identify these nerve branches. The nerve is cut, and to prevent re-growth this branch of the recurrent laryngeal nerve is “re-innervated” to the ansa cervicalis nerve.

This surgery is performed with a patient asleep and typically patients spend some time in the hospital in recovery. Initially a patient may experience breathy hoarseness and some difficulty swallowing items such as thin liquids. However, with time patients usually experience reversal of both.