Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy

Autor: Jean-Paul Marie, Adrien Marronnier, Nicolas Bon-Mardion, Kevin Hansen, Philippe Brami
Přispěvatelé: Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Rouen, Rouen, France, Groupe de Recherche sur le Handicap Ventilatoire (GRHV), Institute for Research and Innovation in Biomedicine (IRIB), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-CHU Rouen, Normandie Université (NU)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Male
Spirometry
medicine.medical_specialty
Adolescent
Voice Quality
[SDV]Life Sciences [q-bio]
Salvage treatment
Vocal Cords
Vocal fold palsy
01 natural sciences
Voice analysis
Young Adult
010104 statistics & probability
03 medical and health sciences
0302 clinical medicine
Humans
Medicine
Prospective Studies
0101 mathematics
Child
030223 otorhinolaryngology
Prospective cohort study
ComputingMilieux_MISCELLANEOUS
Aged
Salvage Therapy
medicine.diagnostic_test
Electromyography
Recurrent Laryngeal Nerve
business.industry
Recovery of Function
Vocal fold paralysis
Middle Aged
Otorhinolaryngologic Surgical Procedures
3. Good health
Laryngeal reinnervation
Surgery
Treatment Outcome
medicine.anatomical_structure
Otorhinolaryngology
Child
Preschool
Female
business
Vocal Cord Paralysis
Follow-Up Studies
Reinnervation
Zdroj: Laryngoscope
Laryngoscope, Wiley, 2019, ⟨10.1002/lary.28324⟩
ISSN: 0023-852X
DOI: 10.1002/lary.28324⟩
Popis: Objectives/hypothesis Demonstration of voice improvement and long-term stability following nonselective unilateral laryngeal reinnervation (ULR) in patients with unilateral vocal fold paralysis (UVFP) and severe denervation. A subgroup of patients on whom ULR was performed as a salvage technique following unsuccessful medialization was analyzed separately. Study design Prospective cohort study. Methods The ansa cervicalis-recurrent laryngeal nerve anastomosis technique was performed in all patients. Pre- and postoperative voice analysis included voice questionnaires, voice assessment by senior laryngologists using the Hirano Voice Scale, and computer-assisted voice analysis at defined time points over the course of 36 months. Laryngeal electromyography (LEMG) and spirometry were performed before and 1 year after ULR. Results Significant linear improvement of mean voice quality over time was observed in the majority of parameters measured in 48 ULR patients and in eight ULR salvage patients. LEMG 1 year after ULR showed new recruitment. Mean voice quality remained stable during follow-up in all ULR patients and in the ULR salvage group. Conclusions Nonselective ULR in UVFP is a reliable and stable therapeutic option for patients with high expectations concerning voice quality. The effect is stable in long-term results. It is also a viable option for patients in whom conventional voice surgery failed to improve voice quality. We therefore propose ULR as salvage option in UVFP. Level of evidence 2b Laryngoscope, 130:1756-1763, 2020.
Databáze: OpenAIRE
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