Functional restoration for recurrent laryngeal paralysis: an experimental study

Area of Science:

• Laryngology
• Neurosurgery
• Surgical Innovation

Background:

• Recurrent laryngeal nerve paralysis can impair vocal cord function, affecting both phonation and respiration.
• Existing surgical treatments for vocal cord paralysis have limitations in fully restoring function.

Purpose of the Study:

• To present a new surgical design aimed at preventing abductor muscle disturbance and maintaining phonation in recurrent laryngeal nerve paralysis.
• To evaluate the efficacy of a novel surgical approach combining muscle pedicle implantation and selective nerve branch severance.

Main Methods:

• The surgical technique involves implanting the ansa hypoglossi and sternothyroid muscle pedicle.
• Selective severance of the abductor branch after neurorrhaphy of the recurrent laryngeal nerve was performed.
• Functional recovery of abductor and adductor functions was assessed.

Main Results:

• The study achieved 67% recovery of abductor function during inspiration and 89% adductor function with phonation.
• In cases of insufficient abduction, severing an adductor nerve branch of the recurrent laryngeal nerve successfully restored vocal cord abduction during inspiration.
• The effectiveness of the ansa hypoglossi and sternothyroid muscle pedicle was evaluated.

Conclusions:

• The novel surgical approach demonstrates significant potential in restoring both vocal cord abduction and adductor function.
• This technique offers a promising solution for managing recurrent laryngeal nerve paralysis, improving respiratory and phonatory outcomes.
• Further research is warranted to fully elucidate the long-term effects and applicability of this surgical innovation.