Laryngeal Reinnervation for Unilateral Vocal Fold Paralysis
Vocal fold immobility due to laryngeal paralysis can often be treated by laryngeal reinnervation. The therapeutic effect is characterized by an muscle gain and a shift to the midline of the paralyzed vocal fold. Oftentimes, a permanent restoration of the voice funtion can be achieved. Here, you will get information on the techniques and indications.
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Surgical Techniques
There are two types of laryngeal reinnervation: selective and non-selecitve. Selective reinnervation aims to restore active movements of the vocal folds and is used to improve breathing in case of BVFP.
Non-selective reinnervation is used for treating hoarseness caused by UVFP with the two effects of muscle gain and medialization of the paralyzed vocal fold. Two different techniques are established:
- the transposition of a nerve-muscle pedicel onto the paralyzed vocal fold (after Harvey Tucker) and
- the microsurgical suture of a small motoric nerve next to the larynx onto the recurrent laryngeal nerve (ANSA-RLN-technique).
The ANSA-RLN-technique can be applied already in early childhood, e.g. the age of three.
Am I suitable for a Laryngeal Reinnervation?
Laryngeal reinnervation can be considered if the UVFP is permanent. In generell, thats the case if no active movements can be observed after a time of twelve months. For UVFP of unknown origin - e.g. without a prior surgery - the procedure can be performed after the expiration of 24 months.
You might not be a suitable candidate if you had a previous radiation theraby in the neck region. Also, prognosis tends to be limited in elderly patients due to a diminished regenerative activity of the nerves.
Case 2: Non-Selective Laryngeal Reinnervation (ANSA-RLN) for Left UVFP after Aortic Reconstructive Surgery
Case 3: Non-Selective Laryngeal Reinnervation (ANSA-RLN) for Right UVFP after Decompression Surgery to Cervical Spine
What additional information might be relevant for you?
You will need some patience! Since the nerve endings need time to sprout and reach the laryngeal muscles, it may take up to six months untill your voice improves noticeably. Because of this delay, a resorbable filler is injected into the vocal fold during the procedure to have an imediate effect and to bridge that waiting time and.
Do you need further advice?
Here, you may find further generell information including means how to get in contact with us.