title: Pediatric recurrent laryngeal nerve reinnervation: A case series and analysis of post-operative outcomes.
abstract: OBJECTIVE
  To provide detailed information about recurrent laryngeal nerve (RLN) reinnervation outcomes in children using objective measures.
  
  
  METHODS
  The records of three pediatric patients with unilateral vocal cord paralysis that underwent RLN reinnervation were retrospectively reviewed. Fundamental frequency (F0), jitter, shimmer, noise-to-harmonic ratio (NHR), and voice phonation (sustained /s/, /z/, /a/) were measured preoperatively and post-operatively at 13, 9, and 33 months (each time period corresponding to one of the three patients).
  
  
  RESULTS
  Mean preoperative and post-operative variables were as follows: shimmer, 9.65±1.02% vs. 4.46±0.71% (p=0.01); NHR, 0.296±0.063 vs. 0.127±0.011 (p=0.04); jitter, 3.57±0.89% vs. 1.46±0.54% (p=0.08); F0, 274.6±35.4Hz vs. 282.2±70.6Hz (p=0.44); maximum phonation time, 7.46±1.40s vs. 9.79±1.84s (p=0.22); /s:z/ ratio, 1.28±0.22 vs.1.07±0.09 (p=0.26).
  
  
  CONCLUSIONS
  There was statistically significant improvement in shimmer and NHR. Jitter improvement approached statistical significance. All other variables failed to show significant improvement among this small sample size. RLN reinnervation for pediatric patients is an option for the treatment of vocal cord paralysis. Further studies with larger cohorts are needed to show the full benefits.
authors.affiliation: The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Farhood
authors.affiliation: The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Reusser
authors.affiliation: The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Bender
authors.affiliation: Texas Voice Center, Houston, TX 77030, USA.
authors.forename: Apurva A
authors.initials: AA
authors.lastname: Thekdi
authors.affiliation: The Department of Otolaryngology-Head & Neck Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: James T
authors.initials: JT
authors.lastname: Albright
authors.affiliation: The Department of Otolaryngology-Head & Neck Surgery, Baylor College of Medicine, Houston, TX 77030, USA. Electronic address: jedmonds337@gmail.com.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Edmonds
mesh_terms: D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures; D012009:Recurrent Laryngeal Nerve / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*
keywords: Cord paralysis; Laryngeal reinnervation; Surgery; Vocal fold