Laryngeal reinnervation using ansa cervicalis for iatrogenic unilateral vocal fold paralysis / 中华普通外科杂志

ABSTRACT

ObjectiveTo evaluate long-term outcome of laryngeal reinnervation using the main branch of the ansa cervicalis for the treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. MethodsFrom Oct.1990 to Jan.2010,a total of 325 UVFP patients who underwent main branch of ansa cervicalis-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled in the study.We retrospectively analyzed the efficacy of the reinnervation surgery using videostroboscopy,vocal function assessment (acoustic analysis,perceptual evaluation and maximum phonation time ),and laryngeal electromyography. ResultsVideostroboscopy showed that the glottic closure,vocal fold edge,vocal fold position,phase symmetry and regularity were significantly improved postoperatively. The vocal function parameters (GRBAS scale,jitter,shimmer,noise to harmonics ratio and maximum phonation time) were also significantly improved postoperatively ( P ＜ 0.01 ),as compared to corresponding preoperative values.Voice recovered to a normal level in 93.5％(304/325)patients,and the effective rate was 98.8％ (321/325). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle. CondusionsLaryngeal reinnervation using the main branch of ansa cervicalis is a feasible and effective approach for treatment of UVFP patients caused by thyroid surgery,with satisfactory long-term results.