Complementary Reinnervation in Unilateral Vocal Fold Paralysis.

Area of Science:

• Otolaryngology
• Neurosurgery
• Speech and Language Pathology

Background:

• Unilateral vocal fold paralysis (UVFP) significantly impairs voice quality and function.
• Current reinnervation techniques may have limitations or risks.

Purpose of the Study:

• To evaluate the efficacy of complementary ansa cervicalis nerve muscle pedicle laryngeal reinnervation (ANMP-LR) for glottal gap closure in UVFP.
• To assess voice outcomes and functional parameters following ANMP-LR.

Main Methods:

• Twelve patients with UVFP underwent ANMP-LR.
• Voice Handicap Index (VHI), perceived roughness and breathiness, maximum phonation time (MPT), sound pressure level (SPLmax), Dysphonia Severity Index (DSI), and glottal gap (GG) were assessed at baseline and up to 24 months post-surgery.

Main Results:

• Significant improvements were observed in VHI, MPT, SPLmax, and GG within 3-6 months post-ANMP-LR.
• These functional gains remained stable up to 24 months.
• A non-significant trend towards further improvement in SPLmax and GG was noted.

Conclusions:

• ANMP-LR is a viable and effective technique for glottal gap closure in UVFP.
• The procedure is technically straightforward and preserves recurrent laryngeal nerve (RLN) function.
• Early reinnervation with ANMP-LR benefits younger patients with insufficient synkinetic reinnervation.