Immediate selective laryngeal reinnervation in vagal paraganglioma patients

J Laryngol Otol. 2018 Sep;132(9):846-851. doi: 10.1017/S0022215118000476. Epub 2018 Sep 5.

Abstract

Objective: This prospective case series aimed to present the outcomes of immediate selective laryngeal reinnervation.

Methods: Two middle-aged women with vagal paraganglioma undergoing an excision operation underwent immediate selective laryngeal reinnervation using the phrenic nerve and ansa cervicalis as the donor nerve. Multidimensional outcome measures were employed pre-operatively, and at 1, 6 and 12 months post-operatively.

Results: The voice handicap index-10 score improved from 23 (patient 1) and 18 (patient 2) at 1 month post-operation, to 5 (patient 1) and 1 (patient 2) at 12 months. The Eating Assessment Tool 10 score improved from 20 (patient 1) and 24 (patient 2) at 1 month post-operation, to 3 (patient 1) and 1 (patient 2) at 12 months. There was slight vocal fold abduction observed in patient one and no obvious abduction in patient two.

Conclusion: Selective reinnervation is safe to perform following vagal paraganglioma excision conducted on the same side. Voice and swallowing improvements were demonstrated, but no significant vocal fold abduction was achieved.

Keywords: Laryngeal Nerve Injuries; Laryngeal Reinnervation; Paraganglioma; Vocal Cord Paralysis; vagus nerve.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cervical Plexus / surgery
  • Cranial Nerve Neoplasms / surgery*
  • Deglutition Disorders / complications
  • Dysphonia / complications
  • Female
  • Humans
  • Laryngeal Nerves / pathology
  • Laryngeal Nerves / surgery*
  • Larynx / pathology
  • Middle Aged
  • Nerve Regeneration / physiology
  • Outcome Assessment, Health Care
  • Paraganglioma / surgery*
  • Phonation / physiology
  • Phrenic Nerve / transplantation*
  • Prospective Studies
  • Vagus Nerve Diseases / pathology
  • Vocal Cord Paralysis / etiology
  • Vocal Cord Paralysis / surgery
  • Vocal Cords / physiopathology
  • Voice / physiology