With the movement of spastic dysphonia from the province of psychiatry to that of otolaryngology in the early 1970s, several hundred patients have found relief for their labored, halting speech by undergoing sectioning of the recurrent laryngeal nerve.
The section method was pioneered by Herbert H. Dedo, MD, associate professor and vice-chairman of otolaryngology at the University of California, San Francisco. In 1976, he reported that the cause of this speech disorder is a disturbance in the proprioceptive control of the vocal cords probably due to a neurotropic viral infection (JAMA [MEDICAL NEWS] 236:1930-1934, 1976), a theory that has gained wide credence.
Sectioning of the nerve results in paralysis of one vocal cord in the paramedian position so that, Dedo theorizes, there is "precompensation" for the condition of the nonparalyzed cord, which easily adducts across the midline to the paralyzed cord. This yields relatively normal phonation.
At the American Laryngological