title: Longitudinal voice outcomes following laryngeal reinnervation via vagus-to-recurrent laryngeal nerve anastomosis after vagal nerve sacrifice: a case series.
abstract: OBJECTIVE
  This study aimed to describe longitudinal voice outcomes of vagus-to-recurrent laryngeal nerve anastomosis following operative vagal nerve sacrifice.
  
  
  METHODS
  Two patients who underwent anastomosis were assessed by a multidisciplinary voice team at 1, 4, 9, 12, and 18 months after vagal sacrifice.
  
  
  RESULTS
  Long-term changes in voice function based on auditory perceptual measures of voice quality and visual perceptual changes in glottal closure were observed and maintained for 18 months after vagus-to-recurrent laryngeal nerve anastomosis in 2 patients with proximal vagal nerve sacrifice. Patients achieved acceptable voice outcomes and elected not to undergo further treatment, which was supported by Voice Handicap Index scores.
  
  
  CONCLUSIONS
  Gradual restoration of voice following operative vagal sacrifice can be achieved over an 18-month period using vagus-to-recurrent laryngeal nerve anastomosis and warrants further investigation in appropriately selected patients.
authors.affiliation: The University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: Greg M
authors.initials: GM
authors.lastname: Ward
authors.affiliation: The University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: Cara
authors.initials: C
authors.lastname: Sauder
authors.affiliation: The University of New Mexico, Albuquerque, New Mexico, USA gtolson@salud.unm.edu.
authors.forename: Garth T
authors.initials: GT
authors.lastname: Olson
authors.affiliation: The University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Nuara
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery; D055154:Dysphonia / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology / Q000601:surgery; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D009442:Neurilemmoma / Q000601:surgery; D010699:Phonation; D011183:Postoperative Complications / Q000175:diagnosis*; D012009:Recurrent Laryngeal Nerve / Q000601:surgery*; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000601:surgery*; D061223:Vagus Nerve Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D014833:Voice Quality
keywords: nerve transfer (reinnervation); recurrent laryngeal nerve injury; speech therapy; vagus nerve injury; vocal cord paralysis