47 year old policing and security strategic officer.

Voice scores: VHI-10: 17, GRBAS: 21122, AVS: 121, EAT-10: 0, RSI: 3

Background: Longstanding history of dysphonia secondary to left vocal cord palsy from schwannoma at jugular foramen which had led to a diagnosis of type 2 neurofibromatosis 10 years ago. Due to the nature of her vocally demanding job, in the last 18 months, she felt her voice is increasingly weak with regular voice breaks and she often struggles with vocal projection and prolonged conversations.

Assessment: Videostrobolaryngoscopy showed limited movement in left cord ab- and ad-duction, immobile left arytenoid and a longitudinal phonatory gap.

LEMG in July 2022 confirmed chronic denervation of left thyroarytenoid muscle. Normal signals in left cricothyroid and right laryngeal muscles.

Outcome: Patient was offered the options of in-office injection medialisation, type 1 Isshiki thyroplasty or non-selective laryngeal re-innervation. Following the discussion of pros and cons of each options, patient has selected non-selective laryngeal reinnervation.