Contralateral laryngeal reinnervation in the patient with the right-sided vocal cord paralysis – case-report

Abstract

Introduction: Paralysis of the nerves supplying the larynx leading to the vocal fold paralysis may have iatrogenic, proliferative, idiopathic or post-traumatic etiology. The most common etiology is iatrogenic, including a complication of the removal of paraganglioma tumors. One of the therapeutic options for vocal cord paralysis in the course of nerve damage is reinnervation of the larynx. One of the most frequently used reinnervation techniques is the anastomosis of the recurrent laryngeal nerve with the cervical ansa, usually ipsilateral or, less often, contralateral. Case presentation: The description concerns a 41-year-old patient with right-sided laryngeal paralysis after removal ofa paraganglioma of the parapharyngeal space, the area of the jugular foramen and the skull base who underwent laryngeal reinnervation using a contralateral cervical ansa. Conclusion: Laryngeal reinnervation procedure involving anastomosis of the recurrent laryngeal nerve with the contralateral cervical ansa allows recovery of the vocal fold function in a situation when the ipsilateral cervical ansa is damaged. This reinnervation involves taking a much longer section of the cervical ansa than in cases of ipsilateral reconstruction. Moreover this method requires creating a tunnel under the prelaryngeal muscles and passing the cervical ansa over the trachea or larynx.