Abstract
Unilateral vocal fold paralysis (UVFP) is one of the most serious problems in conducting surgery for thyroid cancer. Different treatments are available for the management of UVFP including intracordal injection, type I thyroplasty, arytenoid adduction, and laryngeal reinnervations. The effects of immediate recurrent laryngeal nerve (RLN) reconstruction during thyroid cancer surgery with or without UVFP before the surgery were evaluated with videostroboscopic, aerodynamic, and perceptual analyses. All subjects experienced postoperative improvements in voice quality. Particularly, aerodynamic analysis showed that the values for all patients entered normal ranges in both patients with and without UVFP before surgery. Immediate RLN reconstruction has the potential to restore a normal or near-normal voice by returning thyroarytenoid muscle tone and bulk seen with vocal fold denervation. Immediate RLN reconstruction is an efficient and effective approach to the management of RLN resection during surgery for thyroid cancer.
Highlights
Unilateral vocal fold paralysis (UVFP) is one of the most serious problems in the management of thyroid cancer
We report on cases involving the immediate reconstruction of the recurrent laryngeal nerve (RLN) during thyroid cancer surgery in patients with or without UVFP preoperatively and voice outcomes following the procedure with videostroboscopic, aerodynamic, and perceptual analyses
The voices of the patients who underwent the immediate RLN reconstruction began to improve after a certain period postoperatively
Summary
Unilateral vocal fold paralysis (UVFP) is one of the most serious problems in the management of thyroid cancer. The vocal folds may be paralyzed at the time of presentation, or the recurrent laryngeal nerve (RLN) may need to be sacrificed even when the RLN is functioning preoperatively. Laryngeal reinnervation has several advantages over other techniques. It has the potential of restoring a normal or near normal voice. RLN reinnervation can prevent the progressive loss of thyroarytenoid muscle tone and bulk [7, 9, 10] as seen with vocal fold denervation, which can limit the long-term results of the conventional static laryngoplasty procedure
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