title: [Immediate recurrent laryngeal nerve reconstruction in the treatment of thyroid cancer invading the recurrent laryngeal nerve].
abstract: OBJECTIVE
  To explore the application of immediate recurrent laryngeal nerve reconstruction in the treatment of thyroid cancer invading the recurrent laryngeal nerve.
  
  
  METHODS
  Ten patients with thyroid cancer invading unilateral recurrent laryngeal nerve underwent radical surgery and immediate recurrent laryngeal nerve reconstruction. The reconstructive surgical approach included recurrent laryngeal nerve decompression surgery, end-to-end anastomosis of the recurrent laryngeal nerve, anastomosis of ansa cervicalis nerve to the recurrent laryngeal nerve, and nerve-muscle pedicle (NMP) technique. Among the ten patients, one underwent nerve decompression, one underwent end-to-end anastomosis of the recurrent laryngeal nerve, seven had anastomosis of ansa cervicalis to recurrent laryngeal nerve, and one case had anastomosis of ansa cervicalis to recurrent laryngeal nerve combined with nerve-muscle pedicle (NMP) technique. The effect of surgery was evaluated by videolaryngoscopy, maximum phonation time (MPT), phonation efficiency index (PEI) and voice assessment. T-test was used in the statistical analysis.
  
  
  RESULTS
  All of the 10 patients had no complications including tumor recurrence and hypoparathyroidism after the surgery. Their hoarseness symptoms were improved, and the patients returned to normal or near-normal voice. Postoperative videolaryngoscopy showed that paralyzed vocal cord returned to normal muscle tone and volume, and the vocal cord vibration and mucosal wave were symmetric and the patients got good glottal closure. The pre- and post-operative maximum phone times of the patients were (4.52 ± 0.89) s and (11.91 ± 1.87) s, respectively (P < 0.01). The pre- and post-operative phonation efficiency indices were (1.37 ± 0.43) s/L and (4.02 ± 1.33) s/L, respectively (P < 0.05).
  
  
  CONCLUSIONS
  In patients with thyroid cancer invading unilateral recurrent laryngeal nerve, immediate recurrent laryngeal nerve reconstruction following radical surgery of thyroid cancer can effectively achieve recovery in phonation function and improve the quality of life of the patients.
authors.affiliation: Department of Otolaryngology, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Otolaryngology, China-Japan Friendship Hospital, Beijing 100029, China. Email: yangdazhang2000@aliyun.com.
authors.forename: Dazhang
authors.initials: D
authors.lastname: Yang
authors.affiliation: Department of Otolaryngology, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Dandan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Qingling
authors.initials: Q
authors.lastname: Bi
authors.affiliation: Department of Otolaryngology, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Keqiang
authors.initials: K
authors.lastname: Luo
mesh_terms: D000714:Anastomosis, Surgical; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D019635:Neurosurgical Procedures; D010699:Phonation; D011183:Postoperative Complications; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012009:Recurrent Laryngeal Nerve / Q000473:pathology / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery*; D014826:Vocal Cord Paralysis; D014827:Vocal Cords