Nerve branches to the posterior cricoarytenoid muscle may complicate the laryngeal reinnervation procedure

Su, Wan‐Fu; Liu, Shao‐Cheng; Wang, Shwun-De; Su, Wang-Yu; Ma, Kuo‐Hsing; Huang, Tung-Tsun

doi:10.1002/lary.24944

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…Firstly, the interpositioned free nerve graft between PN and RLN was 1 to 2 cm shorter in length than the interpositioned free nerve graft between the thyrohyoid branch and adductor branch of the RLN such that the regenerating axons from the different donor nerves would grow into the laryngeal adductor and abductor muscles at about the same distance. Another important surgical detail is that the IA branch of RLN adductor should be transected intralaryngeally, and the severed distal stump of the IA branch should be ligated completely, whereas the proximal stumps of all adductor branches including IA branch were implanted into PCA muscles to prevent fibers from the phrenic nerve regenerating into laryngeal adductors . Moreover, the regenerating axons from the PN could sprout into the PCA muscles through all RLN branches instead of wasting some branches in the ligated proximal ending of the adductor trunk, as we discussed previously .…”

Section: Discussionmentioning

confidence: 99%

“…These may be the reasons for the low success rate of selective laryngeal reinnervation for BVFP. Inspired by these previous works, and based on our previous achievements in unilateral laryngeal reinnervation and bilateral abductor reinnervation and innervation characteristics of intrinsic laryngeal muscles, we tried a novel and selective reinnervation of the laryngeal abductor and adductors in the hope of restoring both adductive and abductive movements of the vocal folds.…”

Section: Discussionmentioning

confidence: 99%

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Selective reinnervation using phrenic nerve and hypoglossal nerve for bilateral vocal fold paralysis

Zheng

Chen

et al. 2019

The Laryngoscope

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Objective: To evaluate the extent of airway improvement and voice quality in patients with bilateral vocal fold paralysis (BVFP) who underwent selective laryngeal reinnervation surgery.Methods: Seven patients with BVFP caused by thyroid surgeries were enrolled. They underwent selective laryngeal reinnervation surgery. Videostroboscopy data, voice perceptual data (grade [G]), acoustic data, laryngeal electromyography data, and pulmonary function test data were obtained preoperatively and postoperatively.Results: Videostroboscopic videos showed that six patients could achieve moderate-to-maximal abduction in the bilateral vocal folds during inspiration, whereas all patients achieved adduction in the bilateral vocal folds during phonation at 4 to 7 months postoperatively. G score was decreased significantly versus preoperative values (P < 0.05), and vocal functional parameters were improved significantly at 12 months postoperatively (P < 0.05). The aerodynamic parameter of maximum phonation time was significantly longer than the preoperative value (P < 0.05). Most parameters in pulmonary function test recovered to normal reference levels as early as 3 months postoperatively, whereas maximal inspiratory pressure (PImax) values were still slightly lower than normal levels 12 months after surgery. All of these parameters improved significantly versus preoperative values. Electromyographic data at 12 months postoperatively showed full interference potentials in bilateral posterior cricoarytenoid muscles during inspiration and full interference potentials in bilateral thyroarytenoid muscles during phonation in all patients. Moderate electric potentials were seen in left interarytenoid muscle in one failed patient.Conclusion: This new selective laryngeal reinnervation procedure can achieve physiological movements of the bilateral vocal folds in selected patients with BVFP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Selective reinnervation using phrenic nerve and hypoglossal nerve for bilateral vocal fold paralysis

Zheng

Chen

et al. 2019

The Laryngoscope

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“…Potential reasons for failure of PCA muscle reinnervation may be synkinesis through a communicating branch between the PCA and interarytenoid (IA) muscles or delay between onset of the BVFP and LR (Su et al, 2015;van Lith-Bijl et al, 1998). Since no LEMG assessments were performed, it is impossible to determine whether a minimal PCA reinnervation was still achieved or not.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Vocal Outcomes and Voice-Related Quality of Life After Selective Bilateral Laryngeal Reinnervation: A Case Study

Kissel

Lierde

D’haeseleer

et al. 2023

J Speech Lang Hear Res

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Purpose: Bilateral vocal fold paralysis (BVFP) is a severe disorder that can result in respiratory, swallowing, and voice-related problems. Most surgical treatments do not restore laryngeal function and often need to compromise voice quality to preserve respiratory function. Laryngeal reinnervation (LR) may offer a solution to this problem, but literature on longitudinal outcomes of this procedure is scarce. This study aims to report the longitudinal vocal outcomes of BVFP after LR and subsequent voice therapy. Method: The case of a 23-year-old man with BVFP after a traumatic dissection of both recurrent laryngeal nerves is described. Selective bilateral LR of both adductors and abductors was performed 5 months after the onset of BVFP. Voice therapy was provided after the LR procedure. Multidimensional voice assessments, including acoustic, perceptual, and patient-reported outcome measures (PROMs), were conducted 2, 5, 6.5, 8, and 31 months after LR. Results: An improvement of vocal capabilities and voice quality was noticed 6.5 months after LR, after 4.5 months of voice therapy, with normative values after 2.5 years. PROMs showed an improvement of voice-related quality of life, but some limitations to activities of daily living were still present. Inspiratory arytenoid abduction was not observed on laryngeal videostroboscopic findings in this patient, but tracheostomy was not required. Conclusions: Voice therapy after LR helps establish healthy and efficient voice use without increasing compensatory hyperfunctional behavior. More research is needed to examine potential merits of voice therapy in the rehabilitation of vocal and respiratory functions after LR.

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Indikationen zur Tracheostomie

Schneider‐Stickler

Kress

Engels

et al. 2018

Tracheotomie Und Tracheostomaversorgung

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Nerve branches to the posterior cricoarytenoid muscle may complicate the laryngeal reinnervation procedure

Abstract: NA.

Cited by 5 publications

References 19 publications

Selective reinnervation using phrenic nerve and hypoglossal nerve for bilateral vocal fold paralysis

Selective reinnervation using phrenic nerve and hypoglossal nerve for bilateral vocal fold paralysis

Longitudinal Vocal Outcomes and Voice-Related Quality of Life After Selective Bilateral Laryngeal Reinnervation: A Case Study

Indikationen zur Tracheostomie

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