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Bridging gaps between the recurrent laryngeal nerve and ansa cervicalis using autologous nerve grafts.
J Voice. 2013 May; 27(3):381-7.JV

Abstract

OBJECTIVES/HYPOTHESIS

We investigated the clinical efficacy of free nerve grafts in bridging gaps between the recurrent laryngeal nerve (RLN) and ansa cervicalis in patients with unilateral RLN injury.

STUDY DESIGN

We retrospectively reviewed the charts of 14 patients who underwent relevant free nerve grafting and assessed the clinical outcomes of this procedure.

METHODS

Between January 2000 and January 2010, 14 patients with unilateral vocal fold paralysis were enrolled in this study. In all patients, the RLN was resected and free nerve grafts were applied to bridge the gap between the distal stump of the RLN and the anterior root of ansa cervicalis during surgery. Videostroboscopy, acoustic analysis, perceptual evaluation, maximum phonation time (MPT), and laryngeal electromyography (EMG) were performed both preoperatively and postoperatively to assess the clinical outcomes.

RESULTS

Videostroboscopic findings showed that glottic closure, vocal fold edge, vocal fold position, phase symmetry, and phase regularity were significantly improved postoperatively (P<0.05), and no paradoxical movements of vocal folds were observed. Perceptual evaluation showed that overall grade, roughness, breathiness, asthenia, and strain were also significantly decreased postoperatively (P<0.05). The acoustic parameters jitter (local) and shimmer (local) and the mean noise-to-harmonics ratio were significantly lower than the corresponding preoperative values (P<0.05). The postoperative MPT values were also significantly longer than the preoperative values. Laryngeal EMG revealed significant improvement in voluntary motor unit recruitment during phonation postoperatively (P<0.05).

CONCLUSIONS

Free nerve grafting is an effective procedure in bridging the gap between the RLN and ansa cervicalis in patients with unilateral RLN injury, as well as a safe procedure without obvious morbidity. A satisfactory vocal outcome can be obtained.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23490127

Citation

Li, Meng, et al. "Bridging Gaps Between the Recurrent Laryngeal Nerve and Ansa Cervicalis Using Autologous Nerve Grafts." Journal of Voice : Official Journal of the Voice Foundation, vol. 27, no. 3, 2013, pp. 381-7.
Li M, Liu F, Shi S, et al. Bridging gaps between the recurrent laryngeal nerve and ansa cervicalis using autologous nerve grafts. J Voice. 2013;27(3):381-7.
Li, M., Liu, F., Shi, S., Chen, S., Chen, D., & Zheng, H. (2013). Bridging gaps between the recurrent laryngeal nerve and ansa cervicalis using autologous nerve grafts. Journal of Voice : Official Journal of the Voice Foundation, 27(3), 381-7. https://doi.org/10.1016/j.jvoice.2013.01.009
Li M, et al. Bridging Gaps Between the Recurrent Laryngeal Nerve and Ansa Cervicalis Using Autologous Nerve Grafts. J Voice. 2013;27(3):381-7. PubMed PMID: 23490127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bridging gaps between the recurrent laryngeal nerve and ansa cervicalis using autologous nerve grafts. AU - Li,Meng, AU - Liu,Fei, AU - Shi,Song, AU - Chen,Shicai, AU - Chen,Donghui, AU - Zheng,Hongliang, Y1 - 2013/03/13/ PY - 2013/01/05/received PY - 2013/01/14/accepted PY - 2013/3/16/entrez PY - 2013/3/16/pubmed PY - 2013/12/24/medline SP - 381 EP - 7 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 27 IS - 3 N2 - OBJECTIVES/HYPOTHESIS: We investigated the clinical efficacy of free nerve grafts in bridging gaps between the recurrent laryngeal nerve (RLN) and ansa cervicalis in patients with unilateral RLN injury. STUDY DESIGN: We retrospectively reviewed the charts of 14 patients who underwent relevant free nerve grafting and assessed the clinical outcomes of this procedure. METHODS: Between January 2000 and January 2010, 14 patients with unilateral vocal fold paralysis were enrolled in this study. In all patients, the RLN was resected and free nerve grafts were applied to bridge the gap between the distal stump of the RLN and the anterior root of ansa cervicalis during surgery. Videostroboscopy, acoustic analysis, perceptual evaluation, maximum phonation time (MPT), and laryngeal electromyography (EMG) were performed both preoperatively and postoperatively to assess the clinical outcomes. RESULTS: Videostroboscopic findings showed that glottic closure, vocal fold edge, vocal fold position, phase symmetry, and phase regularity were significantly improved postoperatively (P<0.05), and no paradoxical movements of vocal folds were observed. Perceptual evaluation showed that overall grade, roughness, breathiness, asthenia, and strain were also significantly decreased postoperatively (P<0.05). The acoustic parameters jitter (local) and shimmer (local) and the mean noise-to-harmonics ratio were significantly lower than the corresponding preoperative values (P<0.05). The postoperative MPT values were also significantly longer than the preoperative values. Laryngeal EMG revealed significant improvement in voluntary motor unit recruitment during phonation postoperatively (P<0.05). CONCLUSIONS: Free nerve grafting is an effective procedure in bridging the gap between the RLN and ansa cervicalis in patients with unilateral RLN injury, as well as a safe procedure without obvious morbidity. A satisfactory vocal outcome can be obtained. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/23490127/Bridging_gaps_between_the_recurrent_laryngeal_nerve_and_ansa_cervicalis_using_autologous_nerve_grafts_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(13)00010-6 DB - PRIME DP - Unbound Medicine ER -