Acoustic and perceptual evaluation of laryngeal reinnervation by ansa cervicalis transfer

Abstract

These data suggest that laryngeal reinnervation has the potential to bring about a return to normal or near-normal voice in patients with isolated unilateral vocal fold paralysis.

Transaxillary Totally Endoscopic Robot-Assisted Ansa Cervicalis to Recurrent Laryngeal Nerve Reinnervation for Repair of Unilateral Vocal Fold Paralysis

“…Olsen et al reported excellent acoustic and perceptual results in a series of 12 patients. 15 In a series of 8 patiens, Zheng et al reported the return of mucosal waves after the procedure 16 and El-Kashlan et al had normal voices in each of three patients. 17 May and Beery had excellent results in a series of 20 patients undergoing the ansa-cercivalis reinnervation procedure.…”

Ansa-RLN reinnervation for unilateral vocal fold paralysis in adolescents and young adults

“…We do not attribute this to the arytenoid adduction procedure, but to the etiology of their paralysis which results in more profound weakness of the laryngeal muscles, including the superior laryngeal nerve. Less favorable voice results after laryngeal reinnervation in patients with high vagal paralysis have been documented in other series [15]. In these patients, attempts to improve results by concomitant reinnervation of the affected cricothyroid muscle via muscle-nerve-muscle graft from the intact cricothyroid muscle, along with ansa-RLN reinnervation, has been employed [19,21].…”

“…There is no injection material to resorb, shrink, or create an inflammatory granulomatous mass. Other reports have suggested laryngeal reinnervation yields an improved pitch and loudness control of the voice, as opposed to a static implant [14,15]. Local anesthesia needed for medialization laryngoplastic phonosurgery is not a realistic option for children or many adolescents.…”

“…The ansa-RLN procedure was first described in the 1920s, and re-introduced by Crumley and Izdebski [16]. Several other studies have detailed the voice outcomes of this procedure that document its effectiveness in treating dysphonia from unilateral vocal fold paralysis, however very few have reported outcomes in adolescents and young adults [10,15,17,18]. In an updated large case series of ansa-RLN reinnervation procedure in 46 patients with unilateral vocal fold paralysis, the youngest patient was 22 years of age, and the average age was 53 years [19].…”

Laryngeal Reinnervation Using Ansa Cervicalis for Thyroid Surgery-Related Unilateral Vocal Fold Paralysis: A Long-Term Outcome Analysis of 237 Cases

“…Neurorrhaphy of the ansa cervicalis to RLN is one of the most popular laryngeal reinnervation procedures [8]. Anastomosis of a single branch of ansa cervicalis to RLN was re-introduced by Crumley, followed by Miyauchi, Oslon, Lee, Smith and other investigators [8], [9], [10], [11], [12]. Our previous anatomical study demonstrated that there is usually a main branch coming from the loop of ansa cervicalis, and it has two to three branches and innervates the inferior portions of the sternohyoid, sternothyroid and omohyoid muscles.…”