Neurorrhaphy of the recurrent laryngeal nerve

Fong Fu Chou*, Chih Ying Su, Seng Feng Jeng, Kuan Long Hsu, Kei Yun Lu

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

48 Scopus citations

Abstract

BACKGROUND: It has been controversial to anastomose the severed recurrent laryngeal nerve after transection because when severed recurrent nerves are directly anastomosed, the vocal cords do not regain normal movements and are fixed in the median. The objective of this study was to learn whether direct neurorrhaphy is necessary if the recurrent laryngeal nerve is severed during thyroid or parathyroid surgery. STUDY DESIGN: From 1998 to 2001, 12 patients who had a complete recurrent laryngeal nerve injury during thyroid or parathyroid surgery were enrolled into this study. Eight had primary repair of the nerve; four did not have repair because of cancer invasion. Patients were followed with laryngoscopic or laryngovideostroboscopic examination at 3 months and 6 months postoperatively. Subjective ratings of aspiration and voice quality were based on patient reports. Perceptual voice quality was rated according to grade, roughness, breathiness, asthenia, and strain (GRBAS) scales. If a patient's voice quality, aspiration, and GRBAS scales did not improve at 6 months postoperatively, medialization laryngoplasty was considered. RESULTS: Eight patients with immediate repair showed improved voice quality, aspiration, GRBAS scales, and maximum phonation time at 6 months after surgery. A significant decrease of glottal gap was also noted in patients with neurorrhaphy but not in four patients without neurorrhaphy. Medialization laryngoplasty was performed in all four patients without neurorrhaphy in the followup period. Immobilization of the vocal cord was noted in all of them, but only one in the neurorrhaphy group had an atrophy of the cord; all four patients without neurorrhaphy had atrophy. CONCLUSIONS: Neurorrhaphy of the recurrent laryngeal nerve is a simple and effective procedure to improve voice quality, aspiration, GRBAS scales, glottal gap, and maximum phonation time by preventing atrophy of the vocal cord.

Original languageEnglish
Pages (from-to)52-57
Number of pages6
JournalJournal of the American College of Surgeons
Volume197
Issue number1
DOIs
StatePublished - 01 07 2003

Fingerprint

Dive into the research topics of 'Neurorrhaphy of the recurrent laryngeal nerve'. Together they form a unique fingerprint.

Cite this