After doing a good bit of research, it became apparent to me that the highest probability of actually fixing the bane of my existence, i.e. terminating my Spasmodic Dysphonia, was through surgery. But not just any surgery, and not just any surgeon. This post will cover the surgery, called SLAD-R. The next post will cover the surgeon.
There are several different surgical procedures people have used to address Spasmodic Dysphonia, with varying degrees of success. The surgery I selected is called Selective Laryngeal Adductor Denervation-Reinnervation (SLAD-R). To understand what it is, let’s first understand the problem it’s fixing. Basically, a part of the brain is somehow jacked up, such that it misfires and signals specific nerves to tell the vocal chords to do things they should not. This results, for example, in the vocal chords tightening – alot – when they shouldn’t. The upshot of which is strangled, fragmented, sometimes unintelligible speech.
So how did the surgery address this? First, remember I was under general anesthesia, so it was lights out. Night night. Once I was under, the surgeon made an incision in my neck. (That probably sounds better than “the surgeon slit my throat.” Doesn’t have quite the same visceral impact though.) In any case, this must be done to get access to the nerves.
Next, he severed 2 nerves that connect the brain to the vocal chords and are the source of the problems. For any medical geeks that are interested, the nerves are called Recurrent Laryngeal Nerves (one on the right and one on the left of the larynx). This is the “denervation” part of the process.
After that, he basically rewired me by building a new route from my brain to my vocal chords. He took a pair of other nerves (I believe the ANSA cervicalis nerves), that had not been involved in any of the nefarious strangulation activity, and connected them to the cut stumps of the denervation process above. This rewiring is the “reinnervation” process.
The surgery took about 3 hours, which is pretty typical.
As I learned a bit more about the human anatomy, I found that the area in which these nerves are located seems to be pretty densely packed with all sorts of fun stuff like key arteries, as well as paths to the brain controlling important functions. Needless to say, you don’t want somebody mucking around in there that doesn’t know their way around really well. You want somebody that has done this many, many times, and understands the intricacies of what to do, how to do it, and how to recover when things don’t go as planned. My next post will expand on this.
Image source: commons.wikimedia.org