Artificial Nerve Conduit for Recurrent Laryngeal Nerve Reconstruction in Thyroid Surgery

Area of Science:

• Otolaryngology
• Neurosurgery
• Regenerative Medicine

Background:

• Recurrent laryngeal nerve (RLN) reconstruction is crucial after thyroid cancer resection when the nerve is invaded.
• Artificial nerve conduits, commonly used for peripheral nerves, have not been reported for RLN reconstruction.

Purpose of the Study:

• To evaluate the feasibility, safety, and efficacy of a collagen-based artificial nerve conduit for RLN reconstruction.
• To assess voice outcomes following RLN reconstruction using RENERVE® in patients undergoing oncological surgery.

Main Methods:

• Retrospective case series of seven patients undergoing RLN reconstruction with a collagen conduit (RENERVE®).
• Patients included those with preoperative vocal cord paralysis/paresis or functional cords requiring resection due to cancer.
• Voice and laryngeal function were assessed at 1, 3, and 12 months post-surgery.

Main Results:

• No phonetic improvement was observed in patients with severe preoperative vocal cord atrophy.
• Three patients with functional preoperative vocal cords achieved preoperative voice values.
• Two patients with vocal cord paresis showed voice improvement exceeding preoperative levels.

Conclusions:

• This is the first case series reporting artificial nerve conduit use for human RLN reconstruction.
• Artificial nerve conduits may be a favorable option for RLN reconstruction when direct or ansa cervicalis anastomosis is not feasible, especially in patients with good preoperative voice quality.