Primary Nonselective Laryngeal Reinnervation in Iatrogenic Acute Recurrent Laryngeal Nerve Injury: Case Series and Literature Review

Ear Nose Throat J. 2023 Mar;102(3):164-169. doi: 10.1177/0145561321993605. Epub 2021 Feb 9.

Abstract

Treating an acutely injured recurrent laryngeal nerve by primary nonselective laryngeal reinnervation (LR) during thyroidectomy is encouraged to minimize postoperative morbidity. Performing a concurrent transoral temporary injection laryngoplasty (IL) may improve the patient's voice while waiting for the effect of successful reinnervation. Chronological multidimensional voice outcomes (qualitative and quantitative) and combination of the primary nonselective LR with concurrent transoral IL were not explicitly demonstrated in previous cases that published the literature. In this study, the authors presented the multidimensional voice parameters of 3 patients undergoing primary nonselective LR with concurrent IL during thyroidectomy. The parameters were measured at different time points (2 weeks and 1, 3, 6, and 12 months) following the surgery. Laryngeal electromyography was done at 1 to 2 months and 12 months postsurgery. The results showed that the voices, qualitatively and quantitatively, were within normal range at within 3 months postintervention. The parameters were slightly beyond the normal limit at 3 months and returned to normal at 6 months postintervention and beyond. The LEMG depicted evidence of successful reinnervation in which the motor unit was normal comparable to the opposite normal vocal fold.

Keywords: laryngoplasty; neurorrhaphy; primary intervention; recurrent laryngeal nerve; reinnervation; vocal fold palsy.

Publication types

  • Review

MeSH terms

  • Electromyography
  • Humans
  • Iatrogenic Disease
  • Larynx* / surgery
  • Recurrent Laryngeal Nerve / surgery
  • Recurrent Laryngeal Nerve Injuries* / etiology
  • Recurrent Laryngeal Nerve Injuries* / surgery
  • Thyroidectomy / adverse effects
  • Vocal Cord Paralysis* / etiology
  • Vocal Cord Paralysis* / surgery