Voice and Videostroboscopic Analysis after Neurorrhaphy of Recurrent Laryngeal Nerve Injured during Thyroidectomy / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Injury of recurrent laryngeal nerve is one of the major complications of thyroidectomy. One of the treatment options, which has met with some criticism, may be the repair of the injured nerve. This study was designed to investigate the efficiency of the neurorrhaphy of the injured recurrent laryngeal nerve with voice and videostroboscopic analysis. MATERIALS AND METHODS: For the injured recurrent laryngeal nerve, ansa hypoglossi-recurrent laryngeal nerve anastomosis has been performed in 6 patients, and direct end to end anastomosis has been performed in 4 patients. Postoperative parameters of perceptual analysis, acoustic analysis, aerodynamic study, and videostroboscopy after 6 months were compared with those of 11 patients whose recurrent laryngeal nerves were resected and left without neurorrhaphy. RESULTS: Perceptual breathy vocal quality and the aerodynamic parameters were better in anastomosed group, but there were no differences in the acoustic parameters. Medialization of vocal cord and the glottic closure was better in anastomosed group. No patient of the anastomosed group experienced dyspnea due to synkinesis. CONCLUSION: The results of this study indicates that the neurorrhaphy of injured recurrent laryngeal nerve is effective in improving the glottic closure, but unsatisfactory in achieving symmetric glottic tension and mucosa wave during phonation.