Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy

Jong W. Hong, Tai S. Roh, Han Su Yoo, Hyun J. Hong, Hong Shik Choi, Hang-Seok Chang, Cheong S. Park, Young S. Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives/Hypothesis Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well-organized outcome analysis of nerve anastomosis has been insufficient. We performed immediate direct anastomosis of recurrent laryngeal nerves injured during surgery for thyroid cancer, and subsequent patient outcomes were analyzed. Study Design A total 14 patients sustaining recurrent laryngeal nerve injury during thyroidectomy were recruited for the study. Patients undergoing immediate direct reparative anastomosis of the injured nerves constituted the test group, whereas the controls of group 2 (n-=-4) did not. Methods At follow-up, all patients submitted to rigid laryngoscopy at 3, 6, and 12 months postoperatively. Subjective and objective outcomes of the two groups were then compared. Results At 12 months postoperatively, group 1 showed greater improvement in maximum phonation time, glottic gap scores, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, aspiration scoring, and Voice Handicap Index than controls of group 2. Moreover, group 1 showed an improvement in all five categories at 12 months postoperatively, compared with status at 3 months. None of the patients in group 1 showed laryngoscopic evidence of vocal cord atrophy. Conclusion In this study, patients undergoing immediate direct recurrent laryngeal nerve anastomosis demonstrated better phonation and perceptually rated voice quality than those who did not undergo repair. Level of Evidence 3b. Laryngoscope, 124:1402-1408, 2014

Original languageEnglish
Pages (from-to)1402-1408
Number of pages7
JournalLaryngoscope
Volume124
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1

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Recurrent Laryngeal Nerve
Thyroidectomy
Recurrent Laryngeal Nerve Injuries
Phonation
Voice Quality
Laryngoscopes
Asthenia
Control Groups
Laryngoscopy
Vocal Cords
Thyroid Neoplasms
Tongue
Atrophy
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Hong, J. W., Roh, T. S., Yoo, H. S., Hong, H. J., Choi, H. S., Chang, H-S., ... Kim, Y. S. (2014). Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy. Laryngoscope, 124(6), 1402-1408. https://doi.org/10.1002/lary.24450
Hong, Jong W. ; Roh, Tai S. ; Yoo, Han Su ; Hong, Hyun J. ; Choi, Hong Shik ; Chang, Hang-Seok ; Park, Cheong S. ; Kim, Young S. / Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy. In: Laryngoscope. 2014 ; Vol. 124, No. 6. pp. 1402-1408.
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abstract = "Objectives/Hypothesis Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well-organized outcome analysis of nerve anastomosis has been insufficient. We performed immediate direct anastomosis of recurrent laryngeal nerves injured during surgery for thyroid cancer, and subsequent patient outcomes were analyzed. Study Design A total 14 patients sustaining recurrent laryngeal nerve injury during thyroidectomy were recruited for the study. Patients undergoing immediate direct reparative anastomosis of the injured nerves constituted the test group, whereas the controls of group 2 (n-=-4) did not. Methods At follow-up, all patients submitted to rigid laryngoscopy at 3, 6, and 12 months postoperatively. Subjective and objective outcomes of the two groups were then compared. Results At 12 months postoperatively, group 1 showed greater improvement in maximum phonation time, glottic gap scores, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, aspiration scoring, and Voice Handicap Index than controls of group 2. Moreover, group 1 showed an improvement in all five categories at 12 months postoperatively, compared with status at 3 months. None of the patients in group 1 showed laryngoscopic evidence of vocal cord atrophy. Conclusion In this study, patients undergoing immediate direct recurrent laryngeal nerve anastomosis demonstrated better phonation and perceptually rated voice quality than those who did not undergo repair. Level of Evidence 3b. Laryngoscope, 124:1402-1408, 2014",
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Hong, JW, Roh, TS, Yoo, HS, Hong, HJ, Choi, HS, Chang, H-S, Park, CS & Kim, YS 2014, 'Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy', Laryngoscope, vol. 124, no. 6, pp. 1402-1408. https://doi.org/10.1002/lary.24450

Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy. / Hong, Jong W.; Roh, Tai S.; Yoo, Han Su; Hong, Hyun J.; Choi, Hong Shik; Chang, Hang-Seok; Park, Cheong S.; Kim, Young S.

In: Laryngoscope, Vol. 124, No. 6, 01.01.2014, p. 1402-1408.

Research output: Contribution to journalArticle

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N2 - Objectives/Hypothesis Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well-organized outcome analysis of nerve anastomosis has been insufficient. We performed immediate direct anastomosis of recurrent laryngeal nerves injured during surgery for thyroid cancer, and subsequent patient outcomes were analyzed. Study Design A total 14 patients sustaining recurrent laryngeal nerve injury during thyroidectomy were recruited for the study. Patients undergoing immediate direct reparative anastomosis of the injured nerves constituted the test group, whereas the controls of group 2 (n-=-4) did not. Methods At follow-up, all patients submitted to rigid laryngoscopy at 3, 6, and 12 months postoperatively. Subjective and objective outcomes of the two groups were then compared. Results At 12 months postoperatively, group 1 showed greater improvement in maximum phonation time, glottic gap scores, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, aspiration scoring, and Voice Handicap Index than controls of group 2. Moreover, group 1 showed an improvement in all five categories at 12 months postoperatively, compared with status at 3 months. None of the patients in group 1 showed laryngoscopic evidence of vocal cord atrophy. Conclusion In this study, patients undergoing immediate direct recurrent laryngeal nerve anastomosis demonstrated better phonation and perceptually rated voice quality than those who did not undergo repair. Level of Evidence 3b. Laryngoscope, 124:1402-1408, 2014

AB - Objectives/Hypothesis Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well-organized outcome analysis of nerve anastomosis has been insufficient. We performed immediate direct anastomosis of recurrent laryngeal nerves injured during surgery for thyroid cancer, and subsequent patient outcomes were analyzed. Study Design A total 14 patients sustaining recurrent laryngeal nerve injury during thyroidectomy were recruited for the study. Patients undergoing immediate direct reparative anastomosis of the injured nerves constituted the test group, whereas the controls of group 2 (n-=-4) did not. Methods At follow-up, all patients submitted to rigid laryngoscopy at 3, 6, and 12 months postoperatively. Subjective and objective outcomes of the two groups were then compared. Results At 12 months postoperatively, group 1 showed greater improvement in maximum phonation time, glottic gap scores, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, aspiration scoring, and Voice Handicap Index than controls of group 2. Moreover, group 1 showed an improvement in all five categories at 12 months postoperatively, compared with status at 3 months. None of the patients in group 1 showed laryngoscopic evidence of vocal cord atrophy. Conclusion In this study, patients undergoing immediate direct recurrent laryngeal nerve anastomosis demonstrated better phonation and perceptually rated voice quality than those who did not undergo repair. Level of Evidence 3b. Laryngoscope, 124:1402-1408, 2014

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