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Updated: Jun 25, 2026
09:34
Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
22.0K
A Novel Option for Revision Medialization: Repeat Reinnervation.
Ari D Schuman1, Julina Ongkasuwan1
1Department of Otolarygnology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.
The Laryngoscope
|August 10, 2024
Summary
Revision nonselective laryngeal reinnervation (NSLR) successfully restored voice function in a patient with recurrent vocal fold paralysis. This first-ever revision NSLR case demonstrates improved voice quality and patient outcomes, offering a viable alternative to implants.
Area of Science:
- Otolaryngology
- Neurology
- Regenerative Medicine
Background:
- Nonselective laryngeal reinnervation (NSLR) is an effective treatment for vocal fold paralysis, offering comparable voice outcomes to thyroplasty without permanent implants.
- Recurrent or bilateral vocal fold paralysis can occur, necessitating further intervention.
Observation:
- A 51-year-old woman with prior right NSLR for vocal fold paralysis experienced immobility prior to revision anterior cervical diskectomy and fusion (ACDF).
- She presented with reduced phonation time, breathy and asthenic voice, and abnormal voice parameters (high jitter, shimmer, NHR).
- Opting for revision NSLR over thyroplasty, she underwent a cross-neck procedure with a nerve graft.
Findings:
- Post-revision NSLR, the patient showed notable improvements in objective voice measures, including reduced jitter and shimmer, and improved cepstral peak prominence.
- Subjective voice quality improved, with decreased breathiness and asthenia, and a significant reduction in the Voice Handicap Index (VHI) from 35 to 7.
- One-year follow-up demonstrated sustained functional voice recovery.
Implications:
- This case report presents the first documented instance of successful revision nonselective laryngeal reinnervation.
- Revision NSLR is a feasible and effective treatment option for patients with recurrent vocal fold paralysis, particularly those who prefer a reinnervated voice.
- The findings suggest that revision NSLR can restore voice function and improve quality of life in select patients, warranting further investigation.
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