title: [Laryngeal reinnervation for unilateral traumatic recurrent laryngeal nerve injuries].
abstract: OBJECTIVE
  To investigate 5 procedures of laryngeal reinnervation for unilateral vocal cord paralysis induced by traumatic recurrent laryngeal nerve injury.
  
  
  METHODS
  35 cases were selected for our study, all patients had unilateral recurrent laryngeal nerve injury, including 8 for nerve decompression, 6 for end to end anastomosis of recurrent laryngeal nerve, 16 for main branch of ansa cervicalis anastomosis to recurrent laryngeal nerve, 3 for nerve muscular pedicle and 2 for nerve implantation. All cases have been subjected to preoperative and postoperative voice recording, acoustic analysis, videolaryngoscopy, strobscopy and electromyography.
  
  
  RESULTS
  It is found the adductory and abductory motion of the vocal cord restored in 5 cases with less than 4 months course who received nerve decompression. Although functional motion of vocal cord was not seen in two patients who received nerve decompression with a course longer than 4 months and one less than 4 months, and in all cases who received ansa cervicalis anastomosis and end to end anastomosis of recurrent laryngeal nerve, these procedures resulted in medialization of vocal cord and the mass and tension of the reinnervated vocal cord may become much the same as the contralateral normal vocal cord, thus resuming symmetric vibration of the vocal cords and physiological phonation. Nerve muscular pedicle technique and nerve implantation enabled adductory muscles to be reinnervated, thus improving severe hoarseness, but they didn't restore normal voice.
  
  
  CONCLUSIONS
  (1) Nerve decompression seems to be the best procedure in laryngeal reinnervation; (2) Main branch of ansa cervicalis technique raises satisfactory reinnervation of adductor muscles; (3) Selection of the laryngeal reinnervation protocols should depend on the course, severity and type of nerve injury.
authors.affiliation: Department of Otorhinolaryngology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. zhenghl@smmu.edu.cn
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zheng
authors.forename: Shuimiao
authors.initials: S
authors.lastname: Zhou
authors.forename: Zhaoji
authors.initials: Z
authors.lastname: Li
authors.forename: Shicai
authors.initials: S
authors.lastname: Chen
authors.forename: Suqin
authors.initials: S
authors.lastname: Zhang
authors.forename: Wu
authors.initials: W
authors.lastname: Wen
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Shen
authors.forename: Feng
authors.initials: F
authors.lastname: Liu
authors.forename: Yideng
authors.initials: Y
authors.lastname: Huang
authors.forename: Yi
authors.initials: Y
authors.lastname: Cui
authors.forename: Liping
authors.initials: L
authors.lastname: Geng
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000294:innervation; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration; D019635:Neurosurgical Procedures; D012009:Recurrent Laryngeal Nerve / Q000502:physiology / Q000601:surgery; D061226:Recurrent Laryngeal Nerve Injuries; D014826:Vocal Cord Paralysis / Q000601:surgery*