title: Outcomes of Laryngeal Reinnervation for Unilateral Vocal Fold Paralysis in Children: Associations With Age and Time Since Injury.
abstract: OBJECTIVE
  Outcomes of laryngeal reinnervation with ansa-cervicalis for unilateral vocal fold paralysis (UVFP) may be influenced by age of the patient and time interval between laryngeal nerve injury and reinnervation, suggesting less favorable outcomes in older patients and greater than 2-year time interval after injury. This study examines these issues in the pediatric population.
  
  
  METHODS
  Review of prospectively collected data set of 35 children and adolescents (1-21 years) that underwent ansa-recurrent laryngeal nerve (RLN) laryngeal reinnervation for UVFP.
  
  
  RESULTS
  The time from RLN injury to reinnervation averaged 5.0 years (range, 0.8-15.2 years). No correlation was found between age at reinnervation (r = 0.15) and patient- or parent-reported global percentage voice outcome or perceptual ratings. There was slight negative correlation in duration between RLN injury and reinnervation and voice outcomes (r = -0.31). Postoperative voice self/surrogate global percentage rating average was 80.5% (range, 50%-100%), and perceptual rating GRBAS sum score average was 2.9 (range, 0-7).
  
  
  CONCLUSIONS
  In pediatric ansa-RLN reinnervation for UVFP, no correlation between age at surgery and postoperative outcome was found. Denervation duration showed slight negative correlation, similar to what has been reported in adults, though voice improvement was seen in all patients.
authors.affiliation: Division of Otolaryngology/Head and Neck Surgery, The University of Utah School of Medicine, Primary Children's Hospital, Voice Disorders Center at University Hospital, Salt Lake City, Utah, USA Marshall.smith@hsc.utah.edu.
authors.forename: Marshall E
authors.initials: ME
authors.lastname: Smith
authors.affiliation: Voice Disorders Center, University Hospital, Salt Lake City, Utah, USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Houtz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D061224:Laryngeal Nerve Injuries / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D009416:Nerve Regeneration; D011446:Prospective Studies; D020127:Recovery of Function; D012009:Recurrent Laryngeal Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D061226:Recurrent Laryngeal Nerve Injuries / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014827:Vocal Cords / Q000294:innervation*; D055815:Young Adult
keywords: pediatric voice; recurrent laryngeal nerve injury; reinnervation; surgical outcomes; vocal fold paralysis; voice outcomes