Related Experiment Video
Updated: May 16, 2025
Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
Recurrent Laryngeal Nerve Reinnervation and Pediatric Dysphagia Outcomes
Swapnika Alahari1, Rishi Suresh1, Neila Kline1
1Department of Otolaryngology-Head & Neck Surgery, Division of Pediatric Otolaryngology University of Texas Southwestern Medical Center Dallas Texas USA.
Insights
Recurrent laryngeal nerve (RLN) reinnervation effectively resolved aspiration in children with dysphagia, leading to improved swallowing function and diet advancement. Further research is needed to confirm long-term benefits.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Gastroenterology
- Speech-Language Pathology
Background:
- Dysphagia and aspiration are significant challenges in children, often linked to unilateral vocal fold immobility.
- Recurrent laryngeal nerve (RLN) reinnervation offers a potential surgical solution for improving swallowing function.
Purpose of the Study:
- To evaluate the frequency of aspiration resolution following RLN reinnervation in pediatric patients with dysphagia.
- To assess the impact of RLN reinnervation on swallowing function and diet consistency in children.
Main Methods:
- A case series design with retrospective chart review was employed.
- Pediatric patients undergoing RLN reinnervation between 2013 and 2022 were included.
- Video fluoroscopic swallow studies (VFSS) were used to assess swallowing function, including aspiration, before and after the procedure.
Main Results:
- Six children with preoperative and postoperative VFSS data were analyzed from 24 RLN reinnervations.
- Following RLN reinnervation, all analyzed patients demonstrated resolution of aspiration.
- All patients experienced advancements in their oral diet consistencies post-procedure.
Conclusions:
- RLN reinnervation is an effective treatment for resolving dysphagia and enabling diet advancement in children with aspiration and unilateral vocal fold immobility.
- The study highlights the commonality of swallowing function improvement after RLN reinnervation.
- Further investigation is warranted to understand the long-term efficacy of RLN reinnervation for swallowing improvement in pediatric unilateral vocal cord paralysis.
Objective:
To determine the frequency of aspiration resolution after recurrent laryngeal nerve (RLN) reinnervation among children with dysphagia.
Study Design:
Case series with chart review.
Methods:
All pediatric RLN reinnervations between January 2013 and December 2022 at a tertiary aerodigestive program were included. Only children completing video fluoroscopic swallow studies (VFSS) prior to the RLN procedure were analyzed. Postoperative outcomes included swallowing function from VFSS, including thin liquid aspiration.
Results:
Twenty-four RLN reinnervations were reviewed, with six children obtaining both preoperative and postoperative VFSS. Following RLN reinnervation, no patients were noted to aspirate, and all patients had advancement in their diet consistencies.
Conclusions:
Resolution of dysphagia and advancement of the oral diet after RLN reinnervation is common among children with aspiration and unilateral vocal fold immobility. Long-term improvement of swallowing function in children with unilateral vocal cord paralysis corrected by RLN reinnervation must be examined further.
Level Of Evidence:
4.
Related Concept Videos
01:21Larynx
Anatomy of the Larynx
The larynx consists of various components, including cartilage, muscles, and vocal cords. Its structure includes three large unpaired cartilages—the thyroid, cricoid, and epiglottis—and three smaller paired cartilages—the arytenoids,...
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...