Roberto Puxeddu, Valeria Marrosu, Marta Filauro, Cinzia Mariani, Giampiero Parrinello, Kate Heathcote, Clara Gerosa, Melania Tatti, Stefano Manca di Villahermosa, Francesco Mora, Giorgio Peretti, Filippo Carta
{"title":"Bilateral selective laryngeal reinnervation in patients with bilateral vocal cord palsy.","authors":"Roberto Puxeddu, Valeria Marrosu, Marta Filauro, Cinzia Mariani, Giampiero Parrinello, Kate Heathcote, Clara Gerosa, Melania Tatti, Stefano Manca di Villahermosa, Francesco Mora, Giorgio Peretti, Filippo Carta","doi":"10.14639/0392-100X-N2395","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Bilateral selective reinnervation of the larynx aims to restore both vocal cord tone and abductor movements in patients with bilateral vocal cord palsy.</p><p><strong>Methods: </strong>Four females and one male treated by bilateral selective reinnervation of the larynx were included in the present study. In all cases, both posterior cricoarytenoid muscles were reinnervated using the C3 right phrenic nerve root through the great auricular nerve graft, while adductor muscle tone was bilaterally restored using the thyrohyoid branches of the hypoglossal nerve through transverse cervical nerve grafts.</p><p><strong>Results: </strong>After a minimum follow-up of 48 months, all patients were successfully tracheostomy free and had recovered normal swallowing. At laryngoscopy, the first patient recovered a left unilateral partial abductor movement, the second had complete bilateral abductor movements, the third did not show improvements of abductor movements, but symptomatology was improved, the fourth recovered partial bilateral abductor movements and the fifth case did not show improvements and needed posterior cordotomy.</p><p><strong>Conclusions: </strong>Bilateral selective laryngeal reinnervation, although a complex surgical procedure, offers a more physiologic recovery in the treatment of bilateral vocal fold paralysis. Selection criteria still needs to be precisely defined to avoid unexpected failures.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 3","pages":"189-196"},"PeriodicalIF":2.1000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/9d/aoi-2023-03-189.PMC10198368.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Otorhinolaryngologica Italica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.14639/0392-100X-N2395","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Bilateral selective reinnervation of the larynx aims to restore both vocal cord tone and abductor movements in patients with bilateral vocal cord palsy.
Methods: Four females and one male treated by bilateral selective reinnervation of the larynx were included in the present study. In all cases, both posterior cricoarytenoid muscles were reinnervated using the C3 right phrenic nerve root through the great auricular nerve graft, while adductor muscle tone was bilaterally restored using the thyrohyoid branches of the hypoglossal nerve through transverse cervical nerve grafts.
Results: After a minimum follow-up of 48 months, all patients were successfully tracheostomy free and had recovered normal swallowing. At laryngoscopy, the first patient recovered a left unilateral partial abductor movement, the second had complete bilateral abductor movements, the third did not show improvements of abductor movements, but symptomatology was improved, the fourth recovered partial bilateral abductor movements and the fifth case did not show improvements and needed posterior cordotomy.
Conclusions: Bilateral selective laryngeal reinnervation, although a complex surgical procedure, offers a more physiologic recovery in the treatment of bilateral vocal fold paralysis. Selection criteria still needs to be precisely defined to avoid unexpected failures.
期刊介绍:
Acta Otorhinolaryngologica Italica first appeared as “Annali di Laringologia Otologia e Faringologia” and was founded in 1901 by Giulio Masini.
It is the official publication of the Italian Hospital Otology Association (A.O.O.I.) and, since 1976, also of the Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale (S.I.O.Ch.C.-F.).
The journal publishes original articles (clinical trials, cohort studies, case-control studies, cross-sectional surveys, and diagnostic test assessments) of interest in the field of otorhinolaryngology as well as clinical techniques and technology (a short report of unique or original methods for surgical techniques, medical management or new devices or technology), editorials (including editorial guests – special contribution) and letters to the Editor-in-Chief.
Articles concerning science investigations and well prepared systematic reviews (including meta-analyses) on themes related to basic science, clinical otorhinolaryngology and head and neck surgery have high priority.