Ansa cervicalis-to-recurrent laryngeal nerve anastomosis for unilateral vocal fold paralysis: experience of a single institution.
OBJECTIVE
One treatment option for unilateral vocal fold paralysis (UVFP) is ansa cervicalis-to-recurrent laryngeal nerve (ansa-RLN) anastomosis to provide reinnervation to the affected vocal fold. The advantages of this treatment approach are that it 1) provides vocal fold tone, bulk, and tension, 2) is technically simple, and 3) does not preclude other medialization procedures. We present all patients who have undergone ansa-RLN anastomosis for UVFP at our institution.


METHODS
An Institutional Review Board-approved retrospective chart review was performed to include all patients who had undergone an ansa-RLN anastomosis procedure for UVFP at our institution. Data from clinical and endoscopic laryngoscopy with stroboscopy were recorded. Statistical analysis was performed on visual and perceptual vocal data.


RESULTS
A total of 46 patients were included in the study. Stroboscopic analysis and perceptual vocal evaluation was performed in a blinded fashion on the 21 patients who had preoperative and postoperative stroboscopy. Severity, roughness, breathiness, and strain all improved significantly over time. Glottic closure, vocal fold edge, and supraglottic effort all significantly improved after operation. Of the 38 patients with at least 3 months of follow-up, all except 1 demonstrated evidence of reinnervation.


CONCLUSIONS
This technique for treating UVFP results in significant improvements in patients' voice and on visual examination.
Lorenz
Robert R
RR
Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Esclamado
Ramon M
RM
Teker
Aysenur M
AM
Strome
Marshall
M
Scharpf
Joseph
J
Hicks
Douglas
D
Milstein
Claudio
C
Lee
Walter T
WT
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002572:Cervical Plexus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012009:Recurrent Laryngeal Nerve / Q000601:surgery*; D012189:Retrospective Studies; D049489:Stroboscopy; D013536:Suture Techniques; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000503:physiopathology / Q000601:surgery*; D014827:Vocal Cords / Q000294:innervation* / Q000503:physiopathology; D014833:Voice Quality