Selective laryngeal reinnervation for management of bilateral vocal cord paralysis

Abstract

The surgical treatment of bilateral vocal fold paralysis should pro-vide patients with breathing comfort and adequate vocal function without the risk of foreign body aspiration. Bilateral selective la-ryngeal reinnervation appears to fulfill the above criteria while being an innovative method which opens up new horizons while not precluding the option of traditional static surgeries being car-ried out to expand the rima glottidis in cases of previous treatment failure. Proper selection of patients including detailed diagnostic tests is important for the success of the treatment. Selective rein-nervation of posterior cricoarytenoid muscles facilitates the ab-duction of vocal folds upon breathing. Reconstruction of the se-parate innervation of laryngeal muscles prevents the adduction of vocal folds upon inspiration while simultaneously preventing their atrophy and ensuring proper tension. Pulmonary function impro-vement is observed with good voice quality being maintained and no synkinesis being observed. However, selective laryngeal rein-nervation requires high precision and experience in the formation of microsurgical nerve anastomoses. Temporary tracheostomy is also required in patients. Transient aspiration may occur following the procedure and should be prevented. </br> </br> As seen from the cited studies, long-term follow-up results are favorable and bilateral selective laryngeal reinnervation should be included in the protocols for the management of patients with bilateral vocal fold paralysis.