AI Article Synopsis

  • The study examines the effectiveness of ansa cervicalis anterior root-recurrent laryngeal nerve (RLN) anastomosis in treating unilateral vocal fold paralysis (UVFP) in 92 patients over a four-year period.
  • Despite not achieving normal vocal cord movement within 12 months post-surgery, significant improvements in vocal cord muscle tension, volume, and positioning were observed, alongside enhanced glottic closure and vibration symmetry.
  • Patients reported better vocal outcomes as indicated by reductions in perceptual assessments (GRBAS, VHI-10), objective acoustic parameters, and improved laryngeal electromyography results, highlighting the procedure as a safe and effective treatment for RLN injury.

Article Abstract

Investigates the application and clinical efficacy of ansa cervicalis anterior root-recurrent laryngeal nerve(RLN) anastomosis in the treatment of unilateral vocal fold paralysis(UVFP). A prospective study was conducted with 92 UVFP patients admitted to our department from January 2018 to January 2022 who received ansa cervicalis anterior root-RLN anastomosis. The course of nerve injury ranged from 6 to 24 months. Videostroboscopy, voice subjective auditory perceptual assessment(GRBAS), Voice Handicap Index(VHI-10), voice objective acoustic analysis and laryngeal electromyography(EMG) were used to evaluate the efficacy of the operation. Videostroboscopy showed that although the movement of vocal cords did not return to normal 12 months after operation, their volume and muscle tension were significantly improved and their positions were adducted to the median or near-median. Also the glottic closure, vocal cord position, vocal cord edge, symmetry and regularity of vocal cord vibration were significantly improved than pre-operation(<0.01). The five indexes of GRBAS(Grade, Roughness, Breathiness, Asthenia, Strain) and VHI-10, as well as voice acoustic parameters(Jitter, Shimmer, NHR) post-operation were significantly reduced, while the maximum phonation time(MPT) was significantly longer(<0.01). The results of laryngeal EMG indicated that the maximum voluntary motor unit recruitment(VMUR) post-operation was significantly recovered(<0.01), which confirmed that the affected laryngeal muscle obtained effective nerve reinnervation. Ansa cervicalis anterior root-RLN anastomosis can effectively improve the voice function of patients which is safe and satisfactory. It is an ideal method for the treatment of unilateral RLN injury.

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http://dx.doi.org/10.13201/j.issn.2096-7993.2024.10.005DOI Listing

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