Surgical Considerations for Laryngeal Reinnervation and Future Research Directions

Abstract

This paper examines the history, current use, and future directions of laryngeal reinnervation surgery. Nonselective laryngeal reinnervation has been refined as a surgical technique for use in unilateral vocal fold paralysis. Selective laryngeal reinnervation is a viable surgical option for bilateral vocal fold paralysis. The use of laryngeal pacing devices, nimodipine, stem cells, and manipulation of the cellular and chemical microenvironment are future areas of study for laryngeal reinnervation. While both thyroplasty and injection laryngoplasty are highly effective and remain the most popular treatment for unilateral vocal fold paralysis, nonselective laryngeal reinnervation offers several benefits that may help surgeons achieve superior results. Similarly, selective laryngeal reinnervation for treatment of bilateral vocal fold paralysis is a viable alternative to the life changing tracheostomy and potentially preserves laryngeal function better than iterations of posterior cordotomy surgery.