Immediate Ansa Cervicalis-to-Recurrent Laryngeal Nerve Anastomosis for the Management of Recurrent Laryngeal Nerve Infiltration by a Differentiated Thyroid Carcinoma
- 1 March 2020
- journal article
- research article
- Published by S. Karger AG in ORL
- Vol. 82 (2), 93-105
- https://doi.org/10.1159/000505129
Abstract
Objectives: The optimal surgical approach to treat recurrent laryngeal nerve (RLN) infiltration by differentiated thyroid cancer (DTC) remains a subject of debate. This study explored the feasibility and efficiency of immediate ansa cervicalis nerve (ACN)-to-RLN anastomosis for the management of RLN infiltration by DTC. Material and Methods: Fifty-three patients who underwent immediate ACN-to-RLN anastomosis during DTC extirpation were enrolled in the present study. Thirty-seven cases presented with unilateral vocal cord paralysis before the operation (Group A), and another 16 patients presented with normal vocal cord mobility preoperatively (Group B). Multidimensional assessments, videostroboscopy, voice assessment, and laryngeal electromyography (LEMG) were performed preoperatively and postoperatively. Results: All videostroboscopy, voice assessment and LEMG parameters in Group A deteriorated 1 month after the operation and improved 1 year after the operation compared with preoperative data. In Group B, all parameters 1 year after the operation improved significantly compared with the corresponding parameters 1 month after the operation. LEMG in Group A and B provided substantial evidence for the maturation of neural regeneration from ACN and demonstrated that the laryngeal muscles were reinnervated successfully by this procedure. Conclusions: If the RLN is infiltrated by DTC, immediate ACN-to-RLN anastomosis during complete excision of DTC could restore satisfactory phonatory function and does not compromise oncological radicality.This publication has 19 references indexed in Scilit:
- A New Strategy for the Surgical Management of RLN Infiltrated by Well-Differentiated Thyroid CarcinomaBioMed Research International, 2014
- Effect of duration of denervation on outcomes of ansa‐recurrent laryngeal nerve reinnervationThe Laryngoscope, 2014
- Outcome of vocal cord function after partial layer resection of the recurrent laryngeal nerve in patients with invasive papillary thyroid cancerSurgery, 2014
- Should an Involved but Functioning Recurrent Laryngeal Nerve be Shaved or Resected in a Locally Advanced Papillary Thyroid Carcinoma?Annals of Surgical Oncology, 2013
- Laryngeal Reinnervation Using Ansa Cervicalis for Thyroid Surgery-Related Unilateral Vocal Fold Paralysis: A Long-Term Outcome Analysis of 237 CasesPLOS ONE, 2011
- Spontaneous regeneration of recurrent laryngeal nerve following long‐term vocal fold paralysis in humans: Histologic evidenceThe Laryngoscope, 2011
- Modified arytenoid adduction for cancer-related unilateral vocal fold paralysisThe Journal of Laryngology & Otology, 2010
- Papillary thyroid carcinoma with distant metastases: Survival predictors and the importance of local controlSurgery, 2008
- Immediate Recurrent Laryngeal Nerve Reconstruction and Vocal OutcomeThe Laryngoscope, 2006
- Teflon versus Thyroplasty versus Nerve Transfer: A ComparisonAnnals of Otology, Rhinology & Laryngology, 1990