title: Laryngeal reinnervation using ansa cervicalis for thyroid surgery-related unilateral vocal fold paralysis: a long-term outcome analysis of 237 cases.
abstract: OBJECTIVE
  To evaluate the long-term efficacy of delayed laryngeal reinnervation using the main branch of the ansa cervicalis in treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery.
  
  
  BACKGROUND
  UVFP remains a serious complication of thyroid surgery. Up to now, a completely satisfactory surgical treatment of UVFP has been elusive.
  
  
  METHODS
  From Jan. 1996 to Jan. 2008, a total of 237 UVFP patients who underwent ansa cervicalis main branch-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled as UVFP group; another 237 age- and gender-matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and electromyography were performed preoperatively and postoperatively. The mean follow-up period was 5.2±2.7 years, ranging from 2 to 12 years.
  
  
  RESULTS
  Analysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved in the UVFP group (P<0.001, postoperative vs. preoperative). The postoperative parameters of vocal function were also significantly improved in the UVFP group (P<0.001) and showed no statistical differences compared to the control group (P>0.05, respectively). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle.
  
  
  CONCLUSIONS
  Delayed laryngeal reinnervation with the main branch of ansa cervicalis is a feasible and effective approach for treatment of thyroid surgery-related UVFP; it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Donghui
authors.initials: D
authors.lastname: Chen
authors.forename: Shicai
authors.initials: S
authors.lastname: Chen
authors.forename: Ding
authors.initials: D
authors.lastname: Li
authors.forename: Meng
authors.initials: M
authors.lastname: Li
authors.forename: Siwen
authors.initials: S
authors.lastname: Xia
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007830:Larynx / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010243:Paralysis / Q000601:surgery; D010699:Phonation; D011183:Postoperative Complications; D011897:Random Allocation; D012009:Recurrent Laryngeal Nerve / Q000473:pathology; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014827:Vocal Cords / Q000503:physiopathology*