Laryngeal reinnervation with nerve-nerve anastomosis versus laryngeal framework surgery alone: a comparison of safety.
OBJECTIVE
To characterize any additional risks and rate of complication associated with laryngeal reinnervation in comparison to traditional laryngeal framework surgery.


METHODS
Retrospective chart review over a 5-year period.


RESULTS
A total of 16 reinnervation procedures were performed to rehabilitate a paralyzed vocal fold. Of the 16 procedures, 12 (75%) were combined with arytenoid adduction. One reinnervation was aborted due to presence of scar and vascular malformation in the tracheal-esophageal groove. There were no major complications (airway obstruction or death). There were no cases of prolonged dysphagia or aspiration pneumonia; there was one wound infection (6%). Endoscopic findings postoperatively included pharyngeal ecchymoses in three patients (19%), all of whom underwent a simultaneously performed arytenoid adduction. There was a similar incidence of minor complications in traditional framework surgery performed without reinnervation (P > 0.05).


CONCLUSIONS
Laryngeal reinnervation, alone or in combination with laryngeal framework surgery, does not appear to add significant perioperative morbidity. This is the first report to document the safety of laryngeal reinnervation by nerve-nerve anastomosis.
Blumin
Joel H
JH
Division of Laryngology and Professional Voice, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA. jblumin@mcw.edu <jblumin@mcw.edu>
Merati
Albert L
AL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061224:Laryngeal Nerve Injuries; D007823:Laryngeal Nerves / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects; D019635:Neurosurgical Procedures / Q000379:methods*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D014833:Voice Quality