Experience of Cervical Plexus Reinnervation for Patients with Unilateral Recurrent Laryngeal Nerve Invasion or Injury

Abstract

OBJECTIVE To explore the clinical and therapeutic effects of cervical plexus reinnervation for infiltrated or injured unilateral recurrent laryngeal nerve (URLN). METHODS Functional neck dissection for removal of differentiated thyroid carcinoma (DTC) in patients was performed, in which cervical plexus reinnervation was adopted for patients with stage I disease and URLN with injury or with tumor invasion. Outcomes of surgery were evaluated by examination under fibrolaryngoscope, and the patients’ voices were evaluated before and at er surgery. RESULTS All cases were followed up for 3 mon-2 years (average 8 mon). Abductory motion of the vocal cords of 15 patients was completely or partly restored, but 3 patients’ vocal cords were immovable. The recovery rate of abductory motion of the paralyzed vocal cords was 83.33% (15/18). The function of phonation in the 16 patients was restored to normal or near normal limits, and their hoarseness was improved significantly. CONCLUSION Cervical plexus-URLN reinnervation should be considered when treating patients with unilateral vocal cord paralysis. Removing the tumor simultaneously with cervical plexus reinnervation during surgery for repair of unilateral recurrent laryngeal nerve injury was convenient and easy to perform with less functional damage compared with other methods of reinnervation. The abductory motion of vocal cord could be satisfactorily restored by this reinnervation. Surgical performance skills and application of neurotrophic drugs were important for the success of the surgery.

Keywords

• recurrent laryngeal nerve
• reinnervation
• cervical plexus
• unilateral vocal cord paralysis.