Human laryngeal reinnervation: long-term experience with the nerve-muscle pedicle technique

The nerve-muscle pedicle technique for reinnervation of bilateral vocal cord paralysis has now been applied in 45 cases over the past four years. EMG studies, volume flow loop, pulmonary function studies, and the ability to extubate the patient with good to excellent exercise tolerance for day-to-day activity have been used as parameters to judge success or failure of this procedure. To date there has been a primary success rate of 91.1% (41/45) and a long-term success rate of 88.8% (40/45). There has been one serious complication in the entire series and no significant morbidity other than this. Age of the patient and length of paralysis are not necessarily contraindications to the procedure. These results suggest that the nerve-muscle pedicle technique may be successfully used for reinnervation of bilaterally paralyzed vocal cords without sacrificing residual voice, as is the case with arytenoidectomy type procedures.