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Effect of duration of denervation on outcomes of ansa-recurrent laryngeal nerve reinnervation.
Laryngoscope. 2014 Aug; 124(8):1900-5.L

Abstract

OBJECTIVES/HYPOTHESIS

To investigate the efficacy of laryngeal reinnervation with ansa cervicalis among unilateral vocal fold paralysis (UVFP) patients with different denervation durations.

STUDY DESIGN

We retrospectively reviewed 349 consecutive UVFP cases of delayed ansa cervicalis to the recurrent laryngeal nerve (RLN) anastomosis. Potential influencing factors were analyzed in multivariable logistic regression analysis. Stratification analysis performed was aimed at one of the identified significant variables: denervation duration.

METHODS

Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time (MPT), and laryngeal electromyography (EMG) were performed preoperatively and postoperatively. Gender, age, preoperative EMG status and denervation duration were analyzed in multivariable logistic regression analysis. Stratification analysis was performed on denervation duration, which was divided into three groups according to the interval between RLN injury and reinnervation: group A, 6 to 12 months; group B, 12 to 24 months; and group C, > 24 months.

RESULTS

Age, preoperative EMG, and denervation duration were identified as significant variables in multivariable logistic regression analysis. Stratification analysis on denervation duration showed significant differences between group A and C and between group B and C (P < 0.05)-but showed no significant difference between group A and B (P > 0.05) with regard to parameters overall grade, jitter, shimmer, noise-to-harmonics ratio, MPT, and postoperative EMG. In addition, videostroboscopic and laryngeal EMG data, perceptual and acoustic parameters, and MPT values were significantly improved postoperatively in each denervation duration group (P < 0.01).

CONCLUSIONS

Although delayed laryngeal reinnervation is proved valid for UVFP, surgical outcome is better if the procedure is performed within 2 years after nerve injury than that over 2 years.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

24473920

Citation

Li, Meng, et al. "Effect of Duration of Denervation On Outcomes of Ansa-recurrent Laryngeal Nerve Reinnervation." The Laryngoscope, vol. 124, no. 8, 2014, pp. 1900-5.
Li M, Chen S, Wang W, et al. Effect of duration of denervation on outcomes of ansa-recurrent laryngeal nerve reinnervation. Laryngoscope. 2014;124(8):1900-5.
Li, M., Chen, S., Wang, W., Chen, D., Zhu, M., Liu, F., Zhang, C., Li, Y., & Zheng, H. (2014). Effect of duration of denervation on outcomes of ansa-recurrent laryngeal nerve reinnervation. The Laryngoscope, 124(8), 1900-5. https://doi.org/10.1002/lary.24623
Li M, et al. Effect of Duration of Denervation On Outcomes of Ansa-recurrent Laryngeal Nerve Reinnervation. Laryngoscope. 2014;124(8):1900-5. PubMed PMID: 24473920.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of duration of denervation on outcomes of ansa-recurrent laryngeal nerve reinnervation. AU - Li,Meng, AU - Chen,Shicai, AU - Wang,Wei, AU - Chen,Donghui, AU - Zhu,Minhui, AU - Liu,Fei, AU - Zhang,Caiyun, AU - Li,Yan, AU - Zheng,Hongliang, Y1 - 2014/03/19/ PY - 2013/11/15/received PY - 2014/01/03/revised PY - 2014/01/27/accepted PY - 2014/1/30/entrez PY - 2014/1/30/pubmed PY - 2014/9/23/medline KW - Vocal cord paralysis KW - ansa cervicalis KW - denervation duration KW - laryngeal reinnervation KW - recurrent laryngeal nerve SP - 1900 EP - 5 JF - The Laryngoscope JO - Laryngoscope VL - 124 IS - 8 N2 - OBJECTIVES/HYPOTHESIS: To investigate the efficacy of laryngeal reinnervation with ansa cervicalis among unilateral vocal fold paralysis (UVFP) patients with different denervation durations. STUDY DESIGN: We retrospectively reviewed 349 consecutive UVFP cases of delayed ansa cervicalis to the recurrent laryngeal nerve (RLN) anastomosis. Potential influencing factors were analyzed in multivariable logistic regression analysis. Stratification analysis performed was aimed at one of the identified significant variables: denervation duration. METHODS: Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time (MPT), and laryngeal electromyography (EMG) were performed preoperatively and postoperatively. Gender, age, preoperative EMG status and denervation duration were analyzed in multivariable logistic regression analysis. Stratification analysis was performed on denervation duration, which was divided into three groups according to the interval between RLN injury and reinnervation: group A, 6 to 12 months; group B, 12 to 24 months; and group C, > 24 months. RESULTS: Age, preoperative EMG, and denervation duration were identified as significant variables in multivariable logistic regression analysis. Stratification analysis on denervation duration showed significant differences between group A and C and between group B and C (P < 0.05)-but showed no significant difference between group A and B (P > 0.05) with regard to parameters overall grade, jitter, shimmer, noise-to-harmonics ratio, MPT, and postoperative EMG. In addition, videostroboscopic and laryngeal EMG data, perceptual and acoustic parameters, and MPT values were significantly improved postoperatively in each denervation duration group (P < 0.01). CONCLUSIONS: Although delayed laryngeal reinnervation is proved valid for UVFP, surgical outcome is better if the procedure is performed within 2 years after nerve injury than that over 2 years. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/24473920/Effect_of_duration_of_denervation_on_outcomes_of_ansa_recurrent_laryngeal_nerve_reinnervation_ L2 - https://doi.org/10.1002/lary.24623 DB - PRIME DP - Unbound Medicine ER -