Female 68 yr, diagnosed with Laryngeal Dystonia, Adductor Type with tremor. She had already two times (2018, 2020) transoral laser microsurgery, in which a bilateral myoneurectomy of the thyro-arytenoid muscles was performed, with voice improvement of 6 months, on average. Both voice quality and stability were better than with the regular Btx-injections she has had before (8 yrs) her first surgery. Therefore, she is very motivated for a third operation (transoral laser microsurgery), with resection of fibrosis and probably remnants of the medial part of the thyro-arytenoid muscle.