Abstract
ObjectiveTo evaluate the long-term efficacy of delayed laryngeal reinnervation using the main branch of the ansa cervicalis in treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery.Summary of Background DataUVFP remains a serious complication of thyroid surgery. Up to now, a completely satisfactory surgical treatment of UVFP has been elusive.MethodsFrom Jan. 1996 to Jan. 2008, a total of 237 UVFP patients who underwent ansa cervicalis main branch-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled as UVFP group; another 237 age- and gender-matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and electromyography were performed preoperatively and postoperatively. The mean follow-up period was 5.2±2.7 years, ranging from 2 to 12 years.ResultsAnalysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved in the UVFP group (P<0.001, postoperative vs. preoperative). The postoperative parameters of vocal function were also significantly improved in the UVFP group (P<0.001) and showed no statistical differences compared to the control group (P>0.05, respectively). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle.ConclusionsDelayed laryngeal reinnervation with the main branch of ansa cervicalis is a feasible and effective approach for treatment of thyroid surgery-related UVFP; it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality.
Highlights
Vocal fold paralysis (VFP) is one of the most severe complications caused by thyroid surgery-associated recurrent laryngeal nerve (RLN) injury [1]
We firstly reported laryngeal reinnervation using main branch of ansa cervicalis in Unilateral vocal fold paralysis (UVFP) animal models in 1996, and satisfactory or good voice qualities were obtained by this procedure in a small sample of patients with UVFP [14,16,17]
Data from this study indicate that normal or near-normal phonatory quality may be achieved by delayed reinnervation with a main branch of ansa cervicalis anastomosis to RLN
Summary
Vocal fold paralysis (VFP) is one of the most severe complications caused by thyroid surgery-associated recurrent laryngeal nerve (RLN) injury [1]. The incidence of the permanent VFP was 1%–2% despite of the improvements made in surgical techniques and application of intra-operative nerve monitoring [2,3,4]. Unilateral vocal fold paralysis (UVFP) is characterized by varying degrees of hoarseness, poor coughing effort, and occasional aspiration, which impair the quality of life of the patients. Dissatisfied patients often seek legal redress that can lead to costly, time-consuming litigation with the surgeons. To properly handle thyroid surgery-related UVFP is an important issue for these surgeons. If RLN is unexpectedly injured during operation or the involved RLN is removed due to resection of thyroid malignancy, direct
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
