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CASE STUDY
COURSE OF LARYNGEAL FUNCTION RECOVERY AFTER RECONSTRUCTION OF THE LARYNGEAL NERVES
1
Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Poland
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Publication date: 2020-03-31
Corresponding author
Paulina Krasnodębska
Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, 17 Mokra St., Poland; email: p.krasnodebska@ifps.org.p, tel. +48 223 650 351
Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, 17 Mokra St., Poland; email: p.krasnodebska@ifps.org.p, tel. +48 223 650 351
J Hear Sci 2020;10(1):51-56
KEYWORDS
TOPICS
ABSTRACT
Background:
According to the literature, the rate of laryngeal paralysis after thyroid surgery is as high as several percent. For oncolog-ical operations the rate can reach 20%. The return of laryngeal function depends on the degree of nerve damage. Surgical procedures are required to increase the likelihood of nerve function recovery. Three methods of phonosurgery are currently used. The first is based on injecting auto or alloplastic materials into the vocal fold. The second interferes with the skeleton of the laryngeal cartilages; according to the Isshiki clas-sification, it includes type I thyreoplasty (medialisation thyreoplasty), optionally with complementary arytenoid adduction. The third method reconstructs the laryngeal nerves. Combinations of the three methods are increasingly used. Conservative treatment including phoniatric voice rehabilitation should be started as early as possible.
Case report:
The paper presents a case report of a patient after thyroid surgery due to papillary carcinoma, complicated by bilateral laryn-geal paralysis and aphonia.
Conclusions:
Functional Voice Therapy started just after healing of the postoperative wound in the neck eliminated abnormal compensatory mechanisms of phonation. Reconstruction of the laryngeal nerves is an opportunity to quickly return laryngeal function and prevents unwanted secondary functional mechanisms within the vocal organ.
According to the literature, the rate of laryngeal paralysis after thyroid surgery is as high as several percent. For oncolog-ical operations the rate can reach 20%. The return of laryngeal function depends on the degree of nerve damage. Surgical procedures are required to increase the likelihood of nerve function recovery. Three methods of phonosurgery are currently used. The first is based on injecting auto or alloplastic materials into the vocal fold. The second interferes with the skeleton of the laryngeal cartilages; according to the Isshiki clas-sification, it includes type I thyreoplasty (medialisation thyreoplasty), optionally with complementary arytenoid adduction. The third method reconstructs the laryngeal nerves. Combinations of the three methods are increasingly used. Conservative treatment including phoniatric voice rehabilitation should be started as early as possible.
Case report:
The paper presents a case report of a patient after thyroid surgery due to papillary carcinoma, complicated by bilateral laryn-geal paralysis and aphonia.
Conclusions:
Functional Voice Therapy started just after healing of the postoperative wound in the neck eliminated abnormal compensatory mechanisms of phonation. Reconstruction of the laryngeal nerves is an opportunity to quickly return laryngeal function and prevents unwanted secondary functional mechanisms within the vocal organ.
REFERENCES (31)
1.
Calo PG, Pisano G, Medas F. Risk factors in reoperative thyroid surgery for recurrent goitre: our experience. G Chir, 2012;33:335–338.
2.
Hayward NJ, Grodski S, Yeung M. Recurrent laryngeal nerve injury in thyroid surgery: a review. ANZ J Surg, 2013;83(1–2):15–21.
3.
Blitzer A, Brin M, Ramig L. Neurologic Disorders of the Larynx. Thieme 2011; 117-147.
4.
Schneider W, Wolf S, Krause J. Electromyographische Untersuchung und Verlaufsbeobachtung von beidseitigen Rekurrensparesen nach Schilddrusenoperationen. HNO, 1997;45:551-555.
5.
Szkiełkowska A, Miaśkiewicz B, Remacle M, Krasnodębska P, Skarżyński H. Quality of the voice after injection of hyaluronic acid into the vocal fold. Med Sci Mon, 2013;19:276.
6.
Miaśkiewicz B, Szkiełkowska A, Piłka A, Skarżyński H. Assessment of acoustic characteristics of voice in patients after injection laryngoplasty with hyaluronan. Polish Otolaryngol, 2016;70(1):15-23.
7.
Isshiki N, Tanabe M, Sawada M. Arytenoid adduction for unilateral vocal cord paralysis. Arch Otolaryngol, 1978;104:555-558.
8.
Dzodic R, Markovic I, Santrac N, Buta M, Djurisic I, Lukic S. Recurrent laryngeal nerve liberations and reconstructions: a single institution experience. World J Surg, 2016;40(3):644-651.
9.
Miyauchi A, Inoue H, Tomoda C, et al. Improvement in phonation after reconstruction of the recurrent laryngeal nerve in patients with thyroid cancer invading the nerve. Surgery, 2009; 146(6):1056–1062.
10.
Chen SC, Zheng HL, Zhou SM, et al. Nerve exploration and decompression for traumatic recurrent laryngeal nerve injuries induced by thyroid gland surgery. Zhonghua Er Bi Yan Hou Ke Za Zhi, 2004;39(8):464–468.
11.
Lyu Z, Xu W, Zou J, et al. Recurrent laryngeal nerve decompression for bilateral recurrent laryngeal nerve paralyses after thyroid surgery. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2014;49(11):885–888.
12.
Fancello V, Nouraei S, Heathcote K. Role of reinnervation in the management of recurrent laryngeal nerve injury: current state and advances. Curr Opin Otolaryngol Head Neck Surg, 2017; 25(6), 480-485.
13.
Li M, Chen S, Wang W, Chen D, Zhu M, Liu F, Zheng H. Effect of duration of denervation on outcomes of ansa‐recurrent laryngeal nerve reinnervation. Laryngoscope, 2014;124(8):1900-1905.
14.
Zheng H, Zhou S, Chen S, Li Z, Cuan Y. An experimental comparison of different kinds of laryngeal muscle reinnervation. Otolaryngol Head Neck Surg, 1998;119:540-547.
15.
Pei Y, Chang W, Chuang H, Chang C, Fang T. Implications of synkinesis in unilateral vocal fold paralysis. Otolaryngol Head Neck Surg, 2017;157(6):1017-1024.
16.
Krasnodebska P, Domeracka-Kołodziej A, Szkiełkowska A, Mularzuk M, Sokołowska-Łazar D, Wilhelmsen K, Panasiewicz A. Assessment of short-term comprehensive voice therapy in patients with unilateral paralysis of the larynx. Otolaryngol Pol 2018;72(2):35-43.
17.
Krasnodębska P, Szkiełkowska A. Two videostrobokymographic software packages for evaluating Open Quotient of the vocal folds: user report. J Hear Sci, 2017; 7(4):28-32.
18.
Maniecka-Aleksandrowicz B, Domeracka-Kołodziej A. Dysphonia and hoarseness. Magazyn Otolaryngologiczny 2004;3(1):17-25.
19.
Yamada M, Hirano M, Ohkubo H. Recurrent laryngeal nerve paralysis. A 10-year review of 564 patients. Auris Nasus Larynx, 1983;10:1-15.
20.
Daya H, Hosni A, Bejar-Solar I, Evans J, Bailey C. Pediatric vocal fold paralysis: a long term retrospective study. Arch Otolaryngol Head Neck Surg, 2000;126:21-25.
21.
Sanders I, Wu B, Mu L, Li Y, Biller H. The innervation of the human larynx. Arch Otolaryngol Head Neck Surg, 1993;119(9):934-939.
22.
Aronson A, De Santo L. Adductor spastic dysphonia: three years after recurrent laryngeal nerve section. Laryngoscope, 1983;93:1-8.
23.
Sulica L, Brin M, Blitzer A, Stewart C. Botulinum toxin management of adductor spasmodic dysphonia after failed recurrent laryngeal nerve section. Ann Otol Rhinol Laryngol, 2003;112(6), 499-505.
24.
Olson D, Goding G, Michael D, Acoustic and perceptual evaluation of laryngeal reinnervation by ansa cervicalis transfer. Laryngoscope 1998;108:1767-1772.
25.
Maronian N, Waugh P, Robinson L, Hillel A. Electromyographic findings in recurrent laryngeal nerve reinnervation. Ann Otol Rhinol Laryngol, 2003;112:314-323.
27.
D'Alatri L. Role of early voice therapy in patients affected by unilateral vocal fold paralysis. J Laryngol Otol, 2008;122(9):936-941.
28.
Miyauchi, A. Improvement in phonation after reconstruction of the recurrent laryngeal nerve in patients with thyroid cancer invading the nerve. Surgery, 2009;146(6):1056-1062.
29.
Wei W. Contralateral ansa cervicalis‐to‐recurrent laryngeal nerve anastomosis for unilateral vocal fold paralysis: a long‐term outcome analysis of 56 cases. Laryngoscope, 2011;121(5):1027-1034.
30.
Marina M, Marie J, Birchall M. Laryngeal reinnervation for bilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg, 2011;19(6):434-438.
31.
Tanaka S, Minoru H, Keichi C. Some aspects of vocal fold bowing. Ann Otol Rhinol Laryngol 1994;103(5):357-362.
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