Update: Laryngeal Reinnervation for Unilateral Vocal Cord Paralysis With the Ansa Cervicalis

Zheng, Hongliang; Li, Zhaoji; Zhou, Shui‐Hong; Cuan, Yi; Wen, Wang

doi:10.1097/00005537-199612000-00015

Cited by 64 publications

(59 citation statements)

References 15 publications

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“…Olsen et al reported excellent acoustic and perceptual results in a series of 12 patients. 15 In a series of 8 patiens, Zheng et al reported the return of mucosal waves after the procedure 16 and El-Kashlan et al had normal voices in each of three patients. 17 May and Beery had excellent results in a series of 20 patients undergoing the ansa-cercivalis reinnervation procedure.…”

Section: Discussionmentioning

confidence: 99%

Transaxillary Totally Endoscopic Robot-Assisted Ansa Cervicalis to Recurrent Laryngeal Nerve Reinnervation for Repair of Unilateral Vocal Fold Paralysis

Wright

Lobe

2009

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Pediatric unilateral vocal-fold paralysis represents a source of significant morbidity, for which treatment options are quite limited. Conventional management strategies suitable for adults are not appropriate for the developing larynx. In this study, we report the first experience with minimally invasive laryngeal reinnervation. While open techniques for pediatric recurrent laryngeal nerve reinnervation have been performed, these require large, visible incisions, which limit the appeal of this technique. The transaxillary endoscopic approach to the neck significantly reduces pain and recovery time from cervical surgery. In this study, we report the feasibility of transaxillary totally endoscopic robot-assisted laryngeal reinnervation for unilateral vocal-fold paralysis. Operative time was less than 3 hours, and patients were discharged the day of surgery. No postoperative narcotics were required. Initial results are favorable.

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Section: Discussionmentioning

confidence: 99%

Transaxillary Totally Endoscopic Robot-Assisted Ansa Cervicalis to Recurrent Laryngeal Nerve Reinnervation for Repair of Unilateral Vocal Fold Paralysis

Wright

Lobe

2009

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…RLN reinnervation has several advantages over other techniques. It has the potential of restoring a normal or near-normal voice by returning thyroarytenoid muscle tone and bulk [6, 7, 9, 12, 13] in contrast with the conventional laryngoplasty procedure [7]. Reconstruction of the RLN in the management of UVFP during the thyroid cancer surgery is rarely reported [9, 14–18].…”

Section: Discussionmentioning

confidence: 99%

The Role of Immediate Recurrent Laryngeal Nerve Reconstruction for Thyroid Cancer Surgery

Sanuki

Yumoto

Minoda

et al. 2010

Journal of Oncology

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Unilateral vocal fold paralysis (UVFP) is one of the most serious problems in conducting surgery for thyroid cancer. Different treatments are available for the management of UVFP including intracordal injection, type I thyroplasty, arytenoid adduction, and laryngeal reinnervations. The effects of immediate recurrent laryngeal nerve (RLN) reconstruction during thyroid cancer surgery with or without UVFP before the surgery were evaluated with videostroboscopic, aerodynamic, and perceptual analyses. All subjects experienced postoperative improvements in voice quality. Particularly, aerodynamic analysis showed that the values for all patients entered normal ranges in both patients with and without UVFP before surgery. Immediate RLN reconstruction has the potential to restore a normal or near-normal voice by returning thyroarytenoid muscle tone and bulk seen with vocal fold denervation. Immediate RLN reconstruction is an efficient and effective approach to the management of RLN resection during surgery for thyroid cancer.

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“…With the development of microsurgical techniques, considerable success has been achieved in restoring the physiological function of denervated laryngeal muscles by laryngeal reinnervation, thereby enhancing phonation and optimizing vocal quality (Zheng et al 1996;Donghui et al 2010;Li et al 2013Li et al , 2014. However, the efficacy of delayed reinnervation remains unsatisfactory.…”

Section: Introductionmentioning

confidence: 99%

Expression of TGF-<i>β</i>1 and CTGF Is Associated with Fibrosis of Denervated Sternocleidomastoid Muscles in Mice

Liu

Tang

Chen

et al. 2016

Tohoku J. Exp. Med.

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Injury to the recurrent laryngeal nerve often leads to permanent vocal cord paralysis, which has a significant negative impact on the quality of life. Long-term denervation can induce laryngeal muscle fibrosis，which obstructs the muscle recovery after laryngeal reinnervation. However, the mechanisms of fibrosis remain unclear. In this study, we aimed to analyze the changes in the expression of fibrosis-related factors, including transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), and α-smooth muscle actin (α-SMA) in denervated skeletal muscles using a mouse model of accessory nerve transection. Because of the small size, we used sternocleidomastoid muscles instead of laryngeal muscles for denervation experiments. Masson's trichrome staining showed that the grade of atrophy and fibrosis of muscles became more severe with time, but showed a plateau at 4 weeks after denervation, followed by a slow decrease. Quantitative assessment and immunohistochemistry showed that TGF-β1 expression peaked at 1 week after denervation (p < 0.05) and was maintained at its high level until 4 weeks. CTGFand α-SMA-positive muscle cells were detected at 1 week after denervation, peaked at 2 weeks (p < 0.05), and remained at high levels with a subsequent slight decrease for 3-4 weeks. These results suggest that TGF-β1 and CTGF may be involved in the process of denervated skeletal muscle fibrosis. They may induce the differentiation of myoblasts into myofibroblasts, as characterized by the activation of α-SMA. These findings may provide insights on key pathological processes in denervated skeletal muscle fibrosis and develop novel therapeutic strategies.

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Update: Laryngeal Reinnervation for Unilateral Vocal Cord Paralysis With the Ansa Cervicalis

Cited by 64 publications

References 15 publications

Transaxillary Totally Endoscopic Robot-Assisted Ansa Cervicalis to Recurrent Laryngeal Nerve Reinnervation for Repair of Unilateral Vocal Fold Paralysis

Transaxillary Totally Endoscopic Robot-Assisted Ansa Cervicalis to Recurrent Laryngeal Nerve Reinnervation for Repair of Unilateral Vocal Fold Paralysis

The Role of Immediate Recurrent Laryngeal Nerve Reconstruction for Thyroid Cancer Surgery

Expression of TGF-<i>β</i>1 and CTGF Is Associated with Fibrosis of Denervated Sternocleidomastoid Muscles in Mice

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