Does Dysphagia Improve Following Laryngeal Reinnervation for Treatment of Hoarseness in Unilateral Vocal Fold Paralysis?

Büyükatalay, Zahide Çiler; Brisebois, Simon; Şirin, Seher; Meratı, Albert L.

doi:10.1016/j.jvoice.2019.08.005

Cited by 8 publications

(6 citation statements)

References 33 publications

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“…There were 2 studies of LR, with both indicating improvement in dysphagia over time. Sixty‐seven percent of patients in the Buyukatalay et al 44 study and the single patient with dysphagia prior to surgery in the Baki et al 45 study improved after 6 months postoperatively while all patients continued to improve at 12 months. Duration of follow‐up was variable, but when long‐term follow‐up was reported, the rates of recurrent dysphagia symptoms ranged from 0% to 18% with recurrence essentially isolated to reports of IL procedures that were not necessarily intended to provide long‐term medialization 35,39 .…”

Section: Resultsmentioning

confidence: 90%

“…The most common outcome measure was the EAT‐10, which has excellent internal consistency, test‐retest reproducibility, and a strong correlation with aspiration events in patients with dysphagia 48 . The 4 studies using this outcome all noted improvement, with a reduction of 6 points, 44 4.5 points, 12 1 point, 45 and 4.76 points 41 . Seven studies indicated improvement in dysphagia and/or aspiration as a percentage of the cohort without indication of a specific quantitative outcome measure 19,23,25,31–33 .…”

Section: Resultsmentioning

confidence: 99%

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Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta‐analysis

Coulter¹,

Marvin²,

Brigger

et al. 2022

Otolaryngol.--head neck surg.

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Objective To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility (UVFI) in adults. Data Sources Ovid MEDLINE, Embase, Web of Science, and Cochrane Central. Review Methods A structured literature search was utilized, and a 2-researcher systematic review was performed following PRISMA guidelines. Extractable data were pooled, and a quantitative analysis was performed with a random effects model to analyze treatment outcome and complications by procedure. Results A total of 416 publications were screened and 26 met inclusion criteria. Subjects encompassed 959 patients with UVFI who underwent 916 procedures (n = 547, injection laryngoplasty; n = 357, laryngeal framework surgery; n = 12, laryngeal reinnervation). An overall 615 were identified as having dysphagia as a result of UVFI and had individually extractable outcome data, which served as the basis for a quantitative meta-analysis. In general, dysphagia outcomes after all medialization procedures were strongly positive. Quantitative analysis demonstrated a success rate estimate of 90% (95% CI, 75%-100%) for injection laryngoplasty and 92% (95% CI, 87%-97%) for laryngeal framework surgery. The estimated complication rate was 7% (95% CI, 2%-13%) for injection laryngoplasty and 15% (95% CI, 10%-20%) for laryngeal framework surgery, with minor complications predominating. Although laryngeal reinnervation could not be assessed quantitatively due to low numbers, qualitative analysis demonstrated consistent benefit for a majority of patients for each procedure. Conclusion Dysphagia due to UVFI can be improved in a majority of patients with surgical procedures intended to improve glottal competence, with a low risk of complications. Injection laryngoplasty and laryngeal framework surgery appear to be efficacious and safe, and laryngeal reinnervation may be a promising new option for select patients.

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta‐analysis

Coulter¹,

Marvin²,

Brigger

et al. 2022

Otolaryngol.--head neck surg.

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“…In a previous report, immediate ACN-to-RLN anastomosis during surgery fortunately protected phonatory function restoration, and guaranteed oncological radicality (25). In addition, ACNto-RLN anastomosis not only restored a relative normal voice, but also improved dysphagia (26). Moreover, the effect of ACN-to-RLN anastomosis was superior to those of IL and thyroplasty in several studies (27,28).…”

Section: Neuroanastomosis and Reinnervationmentioning

confidence: 86%

A narrative review of current therapies in unilateral recurrent laryngeal nerve injury caused by thyroid surgery

Tian¹,

Pan²,

Chen³

et al. 2022

Gland Surg

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Objective: To summarize and compare current common treatments in recurrent laryngeal nerve injury (RLNI). In addition, we introduced nerve tissue engineering technology in RLNI animal models. This review is a comprehensive summary of current therapies for unilateral RLNI.Background: RLNI is a common complication in thyroid surgery. Although preoperative imaging and intraoperative nerve monitoring are widely applied, some damage to nerves is still inevitable. Currently, advances in nerve repair and regeneration have been made, but relatively few studies have focused on RLNI.In this review, we summarized and compared current common treatments in RLNI. Methods:We searched the literature on PubMed and Web of Science, and chose studies about RLNI in thyroid surgery. Keywords included the following terms: "recurrent laryngeal nerve regeneration", "injection laryngoplasty", "type I thyroplasty", "arytenoid adduction", and "nerve tissue engineering technology". Only English language studies were included. In the section on nerve tissue engineering technology, we described the application in detail in the table below.Conclusions: Currently, the majority of treatments could obtain different effects to some extent, but there are still shortcomings that need to be overcome further overcome. Therefore, potential exploration such as nerve tissue engineering technology is worthy of attention.

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“…Due to defect of the nerve function, patients could experience hoarseness, dysphasia, dysphagia, and even dyspnea after surgery. Effective reconstruction of RLN, even after long time of nerve denervation, could annihilate those symptoms and is associated with better quality of life 8–10 …”

Section: Discussionmentioning

confidence: 99%

A novel method to reconstruct right recurrent laryngeal nerve by transforming into nonrecurrent laryngeal nerve: The end‐to‐free vagal laryngeal branch end anastomosis

Tan

et al. 2021

Head & Neck

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The objective of this study is to demonstrate a novel method for the reconstruction of right recurrent laryngeal nerve (RLN) by transforming into nonrecurrent RLN: the end‐to‐free vagal laryngeal branch end anastomosis. Here we report a case of locally advanced thyroid carcinoma. The patient underwent radical thyroid surgery with inevitably partial RLN resection and immediate right RLN reconstruction at our institution. With the guidance of intraoperative neuromonitoring (IOMN), we completed a novel end‐to‐free vagal laryngeal branch end anastomosis. The whole procedure was deliberately monitored by IOMN. Surgeons can procure adequate free nerve for tension‐free anastomosis by transforming the right RLN into nonrecurrent nerve. Follow‐up laryngoscope showed improved adductory movement of the right arytenoid. The end‐to‐free vagal end anastomosis is an effective way to reconstruct segmental nerve resection of right RLN. Its long‐term postoperative result needs to be further warranted.

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Does Dysphagia Improve Following Laryngeal Reinnervation for Treatment of Hoarseness in Unilateral Vocal Fold Paralysis?

Cited by 8 publications

References 33 publications

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta‐analysis

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta‐analysis

A narrative review of current therapies in unilateral recurrent laryngeal nerve injury caused by thyroid surgery

A novel method to reconstruct right recurrent laryngeal nerve by transforming into nonrecurrent laryngeal nerve: The end‐to‐free vagal laryngeal branch end anastomosis

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