Laryngeal reinnervation for unilateral vocal cord paralysis: long-term results

Since 1976 modified nerve-muscle pedicle reinnervation for restoration of adductor function in unilaterally paralyzed vocal cords has been performed at the Cleveland Clinic. This technique has reserved for patients with "valuable" voices such as clergymen, public speakers, professional singers and actors. It was felt that this technique should offer potential for restoration of quality of voice and in particular of pitch control, superior to that usually obtained by Teflon injection, because of restoration of the ability to tense the vocal cord. In this regard nerve-muscle pedicle reinnervation is potentially superior to any of the other techniques available for medialization of the unilaterally paralyzed cord. At the present time 27 patients have undergone this surgery and have been followed long enough (at least one year) to determine if the procedure was successful or not. All of these have been subjected to preoperative and postoperative voice recordings on high quality tape equipment. Some of them have been subjected to voice printing for vocal analysis. There have been no complications in the group and all but two of the patients have achieved significant voice improvement as a result of the surgery. The details of current technique and demographic data and follow-up will be presented.