title: Long-term efficacy of primary intraoperative recurrent laryngeal nerve reinnervation in the management of thyroidectomy-related unilateral vocal fold paralysis.
abstract: CONCLUSIONS
  Primary intraoperative recurrent laryngeal nerve (RLN) reinnervation techniques demonstrated significant voice improvement at 24 months postoperatively and could be an effective alternative treatment for thyroidectomy-related permanent unilateral vocal fold paralysis (VFP).
  
  
  OBJECTIVE
  To assess the long-term efficacy of intraoperative RLN reinnervation techniques in the management of thyroidectomy-related unilateral VFP.
  
  
  METHODS
  A prospective study was conducted from January 2008 to June 2012 at Soonchunhyang University Bucheon Hospital. Nineteen patients who underwent RLN reinnervation with either direct reinnervation (neurorrhaphy) or ansa cervicalis to RLN (ansa-RLN) anastomosis and completed subjective and objective voice measurement over a 1-year follow-up period were included in this study.
  
  
  RESULTS
  The causes of VFP were cancer involving the RLN (68.4%, 13/19) and iatrogenic nerve transection (31.5%, 6/19). Reinnervation techniques were direct neurorrhaphy (63.2%, 12/19) and ansa-RLN anastomosis (36.8%, 7/19). Subjective parameters such as the Voice Handicap Index (VHI), posterior glottic closure, and mucosal wave demonstrated significant improvement 6 months postoperatively, and the majority of parameters remained stable up to 24 months (p < 0.05). Objective parameters, such as maximum phonation time (MPT), jitter, shimmer, and the harmonics-to-noise ration (HNR), demonstrated significant improvement at 12 months and most remained stable at 24 months (p < 0.05).
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Soonchunhyang University College of Medicine , Bucheon , Korea.
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Lee
authors.forename: Ki Nam
authors.initials: KN
authors.lastname: Park
authors.forename: Sol Kil
authors.initials: SK
authors.lastname: Oh
authors.forename: Chan-Hee
authors.initials: CH
authors.lastname: Jung
authors.forename: Ji-Oh
authors.initials: JO
authors.lastname: Mok
authors.forename: Chul-Hee
authors.initials: CH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D061226:Recurrent Laryngeal Nerve Injuries / Q000209:etiology / Q000601:surgery*; D013061:Speech Acoustics; D013965:Thyroidectomy / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000601:surgery*
keywords: anastomosis; neurorrhaphy; voice improvement