JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2015, Vol. 29 ›› Issue (3): 54-58.doi: 10.6040/j.issn.1673-3770.0.2015.077

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Reinnervation vesus non-reinnervation surgery for vocal fold paralysis

FENG Yun, YANG Dazhang, LÜ Qiuping, LIU Dandan, WANG Naya   

  1. Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
  • Received:2015-02-05 Revised:2015-04-29 Published:2015-06-16

Abstract: Objective To compare the efficacy of reinnervation and non-reinnervation surgery in the treatment of vocal cord paralysis (VCP). Methods ① Of the 21 cases of unilateral vocal cord paralysis (UVCP), 15 were treated with reinnervation (recurrent laryngeal nerve decompression, anastomosis of ansa cervicalis nerve and recurrent laryngeal nerve, anastomosis of end to end of recurrent laryngeal nerve, nerve muscular pedicle technique to lateral cricoarytenoid muscle), and 6 were treated with non-reinnervation (vocal cord autologous fat injection, type Ⅰ thyroplasty using autologous cartilage). ② Of the 16 cases of bilateral vocal cord paralysis (BVCP), 6 were treated with reinnervation (recurrent laryngeal nerve decompression, bilateral nerve muscular pedicle technique to posterior cricoarytenoid muscle), and 10 were treated with non-reinnervation (vocal cord lateralization, endoscopic resection of arytenoid). The therapeutic effects were evaluated with fiber laryngoscope, strobe laryngoscope, and voice assessment. Results ① Of the 15 UVCP cases treated with reinnervation, vocal cord regained different degrees of movement and adduction when pronunciating. Vocal cord vibration and mucosal wave regained symmetry, and glottal closure was good. MPT before and after surgery was 5.51±1.05 and 12.10±1.41 seconds (P<0.01). Of the 6 UVCP cases treated with non-reinnervation treatment, hoarseness symptoms were improved, but there was no movement of the vocal cords. MPT before and after surgery was 5.47±0.45 and 11.83±1.47 seconds (P<0.01). The difference between MPT of reinnervation and non-reinnervation surgery was not statistically significant (P>0.05). ② Of the 6 BVCP cases treated with reinnervation, 4 had partial vocal cord abduction restored and dyspnea was relieved. Of the 10 BVCP cases treatedwith non-innervation surgery, dyspnea was relieved. Decannulated rate of cases treated with reinnervation and non-reinnervation was 66.7% (4/6) and 100% (10/10), respectively. The difference between the two groups was not statistically significant as analyzed with Fisher exact test (P>0.05). Conclusion Reinnervation and non-reinnervation surgery have considerably good therapeutic effects on UVCP, and the former has a better long-term efficacy. In BVCP, non-reinnervation has better therapeutic effect than reinnervation, but the latter can maintain voice quality. Surgical treatment should be chosen based on surgeons’ expertise, and patients’ physical condition and needs.

Key words: Vocal cord paralysis, Recurrent laryngeal nerve, Reinnervation surgery, Non-reinnervation surgery

CLC Number: 

  • R767.4
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