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Unilateral recurrent laryngeal nerve paralysis
1Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange 92668.
Summary
Recurrent laryngeal nerve (RLN) injury causes vocal fold paralysis, leading to voice loss and aspiration. Nerve transfer surgery offers superior voice restoration compared to other treatments for RLN injuries.
Area of Science:
- Neurology
- Otolaryngology
- Speech and Voice Science
Background:
- Recurrent laryngeal nerve (RLN) injury is the most common traumatic neurolaryngological lesion.
- Acute effects include vocal fold flaccidity, dysphonia, and aspiration.
- The article reviews intrinsic laryngeal muscle function and RLN transection effects.
Purpose of the Study:
- To review the function of intrinsic laryngeal muscles innervated by the RLN.
- To discuss the progression from acute denervation to chronic denervation or reinnervation.
- To explore treatment options for RLN injury, including nerve transfer.
Main Methods:
- Review of existing literature on RLN injury and function.
- Discussion of four possible post-denervation scenarios: complete reinnervation with synkinesis, partial reinnervation with synkinesis, mixed RLN injuries, and complete paralysis.
- Analysis of diagnostic challenges, including the role of electromyography.
Main Results:
- RLN injury leads to vocal fold dysfunction, impacting voice and airway protection.
- Potential outcomes range from full recovery with synkinesis to complete paralysis.
- Current diagnostic tools like EMG have limitations in confirming laryngeal synkinesis.
- Surgical treatments include Teflon injection, thyroplasty, arytenoid adduction, and nerve transfer.
Conclusions:
- Nerve transfer surgery is presented as a preferred method for treating RLN injuries.
- The author reports superior phonatory voice outcomes with nerve transfer compared to other techniques.
- Further research and normative data are needed for definitive diagnosis of laryngeal synkinesis.