title: Clinical review: Current concepts in the management of unilateral recurrent laryngeal nerve paralysis after thyroid surgery.
abstract: OBJECTIVE
  This study was designed to provide an update on the pathophysiological concepts and patient management in a common complication of thyroid surgery, unilateral recurrent laryngeal nerve paralysis (URLNP).
  
  
  METHODS
  Recent publications in physiology and head and neck surgery were reviewed.
  
  
  RESULTS
  Even for experienced surgeons, URLNP may occur after thyroid surgery, especially for thyroid cancer and in case of reoperation. URLNP is frequently well tolerated but may be life threatening by inducing aspiration pneumonia. Permanent URLNP may decrease quality of life by decreasing voice quality and increasing vocal effort. Spontaneous recovery of vocal function, with or without full recovery of vocal fold motion, may occur due to spontaneous axonal regrowth or other neurological phenomena. In the last decade, several surgical techniques have been developed to treat aspiration and poor voice quality due to URLNP by medialization of the paralyzed vocal fold. These techniques are simple, have a low complication rate, and are highly efficient in eliminating aspiration and improving voice quality and quality of life.
  
  
  CONCLUSIONS
  The voice and swallowing handicap caused by URLNP may be efficiently treated by safe and simple techniques. The possibility to improve the quality of life should be proposed to all patients with symptomatic URLNP.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Institut Gustave Roussy, rue Camille Desmoulins, 94805 Villejuif Cédex, France. hartl@igr.fr
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hartl
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Travagli
authors.forename: Sophie
authors.initials: S
authors.lastname: Leboulleux
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Brasnu
authors.forename: Martin
authors.initials: M
authors.lastname: Schlumberger
mesh_terms: D006801:Humans; D011183:Postoperative Complications / Q000628:therapy*; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology; D013961:Thyroid Gland / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000503:physiopathology / Q000628:therapy*