Non-selective laryngeal reinnervation in thyroid surgery

Aim. To evaluate the results of the voice disorders correction in unilateral abduction paralysis of larynx by the anastomosis “ansa cervicalis – recurrent laryngeal nerve” during primary and repeated thyroid surgery. Materials and methods. Surgical non-selective laryngeal reinnervation (primary,...

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Main Authors: V. O. Palamarchuk, O. A. Tovkai, V. V. Voitenko, N. V. Solomennikova
Format: Article
Language:English
Published: Zaporozhye State Medical University 2020-10-01
Series:Zaporožskij Medicinskij Žurnal
Subjects:
Online Access:http://zmj.zsmu.edu.ua/article/view/214739/214893
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author V. O. Palamarchuk
O. A. Tovkai
V. V. Voitenko
N. V. Solomennikova
author_facet V. O. Palamarchuk
O. A. Tovkai
V. V. Voitenko
N. V. Solomennikova
author_sort V. O. Palamarchuk
collection DOAJ
description Aim. To evaluate the results of the voice disorders correction in unilateral abduction paralysis of larynx by the anastomosis “ansa cervicalis – recurrent laryngeal nerve” during primary and repeated thyroid surgery. Materials and methods. Surgical non-selective laryngeal reinnervation (primary, delayed) by anastomosis “ansa cervicalis – recurrent laryngeal nerve” was performed in 49 patients with abduction paralysis of larynx, 45 of whom had ipsilateral and 4 contralateral anastomosis. In the pre- and postoperative periods, all patients underwent indirect laryngoscopy, video laryngoscopy using a Karl Storz fibrolaryngoscope with archiving in the original database, voice spectral analysis and survey using the VHI-30 questionnaire (a modified version).The follow-up period was from 1 to 3 years, an average of 12–18 months. Results. Analysis of the videolaryngoscopic picture results in the postoperative period in the main group showed a significant improvement in spatial location of moving elements of the larynx both within the group (P < 0.01) and in comparison with patients who underwent conservative treatment of laryngeal phonatory dysfunction. Voice spectral analysis and VHI-30 score also improved significantly (P < 0.01) and did not statistically differ from patients with normal laryngeal phonatory function (P > 0.05). With the successful non-selective laryngeal reinnervation, a medialization of paralyzed vocal cord was noted, which significantly improved the phonatory function of larynx, but did not restore its mobility. Conclusions. The method of non-selective laryngeal reinnervation by the anastomosis “ansa cervicalis – recurrent laryngeal nerve” is an effective method for correcting phonatory disorders in unilateral abduction paralysis of the larynx during primary and repeated thyroid surgery and can improve the voice function of the larynx to almost normal state without negative changes in the external respiration function.
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spelling doaj.art-4305e11f40db4b21a4f53b105b6eda752022-12-21T22:40:33ZengZaporozhye State Medical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102020-10-0122566466910.14739/2310-1210.2020.5.214739Non-selective laryngeal reinnervation in thyroid surgeryV. O. Palamarchuk0https://orcid.org/0000-0001-9554-4817O. A. Tovkai1https://orcid.org/0000-0002-1329-279XV. V. Voitenko2https://orcid.org/0000-0002-4627-9364N. V. Solomennikova3https://orcid.org/0000-0001-9920-8861 Ukrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of MoH of Ukraine, KyivUkrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of MoH of Ukraine, KyivUkrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of MoH of Ukraine, Kyiv Ukrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of MoH of Ukraine, Kyiv.Aim. To evaluate the results of the voice disorders correction in unilateral abduction paralysis of larynx by the anastomosis “ansa cervicalis – recurrent laryngeal nerve” during primary and repeated thyroid surgery. Materials and methods. Surgical non-selective laryngeal reinnervation (primary, delayed) by anastomosis “ansa cervicalis – recurrent laryngeal nerve” was performed in 49 patients with abduction paralysis of larynx, 45 of whom had ipsilateral and 4 contralateral anastomosis. In the pre- and postoperative periods, all patients underwent indirect laryngoscopy, video laryngoscopy using a Karl Storz fibrolaryngoscope with archiving in the original database, voice spectral analysis and survey using the VHI-30 questionnaire (a modified version).The follow-up period was from 1 to 3 years, an average of 12–18 months. Results. Analysis of the videolaryngoscopic picture results in the postoperative period in the main group showed a significant improvement in spatial location of moving elements of the larynx both within the group (P < 0.01) and in comparison with patients who underwent conservative treatment of laryngeal phonatory dysfunction. Voice spectral analysis and VHI-30 score also improved significantly (P < 0.01) and did not statistically differ from patients with normal laryngeal phonatory function (P > 0.05). With the successful non-selective laryngeal reinnervation, a medialization of paralyzed vocal cord was noted, which significantly improved the phonatory function of larynx, but did not restore its mobility. Conclusions. The method of non-selective laryngeal reinnervation by the anastomosis “ansa cervicalis – recurrent laryngeal nerve” is an effective method for correcting phonatory disorders in unilateral abduction paralysis of the larynx during primary and repeated thyroid surgery and can improve the voice function of the larynx to almost normal state without negative changes in the external respiration function.http://zmj.zsmu.edu.ua/article/view/214739/214893thyroid glandunilateral laryngeal paralysisrecurrent laryngeal nervevocal cordsansa cervicalis
spellingShingle V. O. Palamarchuk
O. A. Tovkai
V. V. Voitenko
N. V. Solomennikova
Non-selective laryngeal reinnervation in thyroid surgery
Zaporožskij Medicinskij Žurnal
thyroid gland
unilateral laryngeal paralysis
recurrent laryngeal nerve
vocal cords
ansa cervicalis
title Non-selective laryngeal reinnervation in thyroid surgery
title_full Non-selective laryngeal reinnervation in thyroid surgery
title_fullStr Non-selective laryngeal reinnervation in thyroid surgery
title_full_unstemmed Non-selective laryngeal reinnervation in thyroid surgery
title_short Non-selective laryngeal reinnervation in thyroid surgery
title_sort non selective laryngeal reinnervation in thyroid surgery
topic thyroid gland
unilateral laryngeal paralysis
recurrent laryngeal nerve
vocal cords
ansa cervicalis
url http://zmj.zsmu.edu.ua/article/view/214739/214893
work_keys_str_mv AT vopalamarchuk nonselectivelaryngealreinnervationinthyroidsurgery
AT oatovkai nonselectivelaryngealreinnervationinthyroidsurgery
AT vvvoitenko nonselectivelaryngealreinnervationinthyroidsurgery
AT nvsolomennikova nonselectivelaryngealreinnervationinthyroidsurgery