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. 2020 Jul;130(7):1756-1763.
doi: 10.1002/lary.28324. Epub 2019 Oct 21.

Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy

Jean-Paul Marie  1   2   3 , Kevin Hansen  1 , Philippe Brami  1 , Adrien Marronnier  1 , Nicolas Bon-Mardion  1   2   3
Affiliations

Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy

Jean-Paul Marie et al. Laryngoscope. 2020 Jul.

Abstract

Objectives/hypothesis: Demonstration of voice improvement and long-term stability following nonselective unilateral laryngeal reinnervation (ULR) in patients with unilateral vocal fold paralysis (UVFP) and severe denervation. A subgroup of patients on whom ULR was performed as a salvage technique following unsuccessful medialization was analyzed separately.

Study design: Prospective cohort study.

Methods: The ansa cervicalis-recurrent laryngeal nerve anastomosis technique was performed in all patients. Pre- and postoperative voice analysis included voice questionnaires, voice assessment by senior laryngologists using the Hirano Voice Scale, and computer-assisted voice analysis at defined time points over the course of 36 months. Laryngeal electromyography (LEMG) and spirometry were performed before and 1 year after ULR.

Results: Significant linear improvement of mean voice quality over time was observed in the majority of parameters measured in 48 ULR patients and in eight ULR salvage patients. LEMG 1 year after ULR showed new recruitment. Mean voice quality remained stable during follow-up in all ULR patients and in the ULR salvage group.

Conclusions: Nonselective ULR in UVFP is a reliable and stable therapeutic option for patients with high expectations concerning voice quality. The effect is stable in long-term results. It is also a viable option for patients in whom conventional voice surgery failed to improve voice quality. We therefore propose ULR as salvage option in UVFP.

Level of evidence: 2b Laryngoscope, 130:1756-1763, 2020.

Keywords: Laryngeal reinnervation; dysphonia; laryngeal synkinesis; unilateral vocal fold paralysis.

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References

BIBLIOGRAPHY

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