Recurrent laryngeal nerve dissection: a case report involving return of spastic dysphonia after initial surgery.

This case study describes successful management of spastic dysphonia using a procedure whereby the right recurrent laryngeal nerve was severed. Thirteen months following the surgical treatment, the subject reported a return of the preoperative vocal characteristics of spastic dysphonia. Tests and inspection revealed that the right recurrent nerve was again intact and the right vocal fold was functional. A second surgical procedure was performed, modified to prevent neural reconnection, with a return of the improved voice observed following the initial surgery. The results are discussed in terms of etiological considerations of spastic dysphonia.