Tags

Type your tag names separated by a space and hit enter

Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy.
Laryngoscope. 2020 07; 130(7):1756-1763.L

Abstract

OBJECTIVES/HYPOTHESIS

Demonstration of voice improvement and long-term stability following nonselective unilateral laryngeal reinnervation (ULR) in patients with unilateral vocal fold paralysis (UVFP) and severe denervation. A subgroup of patients on whom ULR was performed as a salvage technique following unsuccessful medialization was analyzed separately.

STUDY DESIGN

Prospective cohort study.

METHODS

The ansa cervicalis-recurrent laryngeal nerve anastomosis technique was performed in all patients. Pre- and postoperative voice analysis included voice questionnaires, voice assessment by senior laryngologists using the Hirano Voice Scale, and computer-assisted voice analysis at defined time points over the course of 36 months. Laryngeal electromyography (LEMG) and spirometry were performed before and 1 year after ULR.

RESULTS

Significant linear improvement of mean voice quality over time was observed in the majority of parameters measured in 48 ULR patients and in eight ULR salvage patients. LEMG 1 year after ULR showed new recruitment. Mean voice quality remained stable during follow-up in all ULR patients and in the ULR salvage group.

CONCLUSIONS

Nonselective ULR in UVFP is a reliable and stable therapeutic option for patients with high expectations concerning voice quality. The effect is stable in long-term results. It is also a viable option for patients in whom conventional voice surgery failed to improve voice quality. We therefore propose ULR as salvage option in UVFP.

LEVEL OF EVIDENCE

2b Laryngoscope, 130:1756-1763, 2020.

Authors+Show Affiliations

Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Rouen, Rouen, France. Ventilary Handicap Research Group, University of Rouen, Rouen, EA 3830 GRHV, France. University Hospital Federation SURFACE, Regenerative surgery in Head and Neck, Amiens, France.Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Rouen, Rouen, France.Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Rouen, Rouen, France.Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Rouen, Rouen, France.Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Rouen, Rouen, France. Ventilary Handicap Research Group, University of Rouen, Rouen, EA 3830 GRHV, France. University Hospital Federation SURFACE, Regenerative surgery in Head and Neck, Amiens, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31633818

Citation

Marie, Jean-Paul, et al. "Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy." The Laryngoscope, vol. 130, no. 7, 2020, pp. 1756-1763.
Marie JP, Hansen K, Brami P, et al. Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy. Laryngoscope. 2020;130(7):1756-1763.
Marie, J. P., Hansen, K., Brami, P., Marronnier, A., & Bon-Mardion, N. (2020). Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy. The Laryngoscope, 130(7), 1756-1763. https://doi.org/10.1002/lary.28324
Marie JP, et al. Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy. Laryngoscope. 2020;130(7):1756-1763. PubMed PMID: 31633818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy. AU - Marie,Jean-Paul, AU - Hansen,Kevin, AU - Brami,Philippe, AU - Marronnier,Adrien, AU - Bon-Mardion,Nicolas, Y1 - 2019/10/21/ PY - 2019/03/13/received PY - 2019/07/11/revised PY - 2019/08/19/accepted PY - 2019/10/22/pubmed PY - 2020/10/21/medline PY - 2019/10/22/entrez KW - Laryngeal reinnervation KW - dysphonia KW - laryngeal synkinesis KW - unilateral vocal fold paralysis SP - 1756 EP - 1763 JF - The Laryngoscope JO - Laryngoscope VL - 130 IS - 7 N2 - OBJECTIVES/HYPOTHESIS: Demonstration of voice improvement and long-term stability following nonselective unilateral laryngeal reinnervation (ULR) in patients with unilateral vocal fold paralysis (UVFP) and severe denervation. A subgroup of patients on whom ULR was performed as a salvage technique following unsuccessful medialization was analyzed separately. STUDY DESIGN: Prospective cohort study. METHODS: The ansa cervicalis-recurrent laryngeal nerve anastomosis technique was performed in all patients. Pre- and postoperative voice analysis included voice questionnaires, voice assessment by senior laryngologists using the Hirano Voice Scale, and computer-assisted voice analysis at defined time points over the course of 36 months. Laryngeal electromyography (LEMG) and spirometry were performed before and 1 year after ULR. RESULTS: Significant linear improvement of mean voice quality over time was observed in the majority of parameters measured in 48 ULR patients and in eight ULR salvage patients. LEMG 1 year after ULR showed new recruitment. Mean voice quality remained stable during follow-up in all ULR patients and in the ULR salvage group. CONCLUSIONS: Nonselective ULR in UVFP is a reliable and stable therapeutic option for patients with high expectations concerning voice quality. The effect is stable in long-term results. It is also a viable option for patients in whom conventional voice surgery failed to improve voice quality. We therefore propose ULR as salvage option in UVFP. LEVEL OF EVIDENCE: 2b Laryngoscope, 130:1756-1763, 2020. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/31633818/Nonselective_Reinnervation_as_a_Primary_or_Salvage_Treatment_of_Unilateral_Vocal_Fold_Palsy_ L2 - https://doi.org/10.1002/lary.28324 DB - PRIME DP - Unbound Medicine ER -