Dynamic Reconstruction for Unilateral Vocal Cord Paralysis:Clinical Application of the Cricothyroid-lateral Cricoarytenoid Muscle Suturing

概要

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Although many attempts to remobilize paralyzed cords using, for example, nerve-to-nerve anastomosis or a nerve-muscle pedicle flap have been made, they have not gained wide acceptance in clinical use for the treatment of unilateral recurrent laryngeal nerve paralysis. The problem lies in the weakness of reinnervated muscle which is unavoidably caused by muscle atrophy or misdirection in the reinnervating process<BR>Even in the presence of unilateral recurrent laryngeal nerve paralysis, normal cricothyroid muscle movement is preserved as long as external branch of superior laryngeal nerve remains intact. Therefore, we designed a new procedure using the cricothyroid-lateral cricoarytenoid muscle suturing as a dynamic reconstruction method for unilateral recurrent laryngeal nerve paralysis. This paper reports its clinical application in three patients with various degress of laryngeal paralysis.<BR>Postoperative observations made during a period 2 to 6 months after the surgery revealed active movement to tense the paralysed cord during phonation in every case. Obvious remobilization was obtained in one case. The voice quality in every case was dramatically improved. Thus, we conclude that this method will be useful clinically as a new dynamic reconstruction method for selected cases of unilateral vocal cord paralysis.
The Japan Laryngological Associationの論文