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Hongliang Zheng - One of the best experts on this subject based on the ideXlab platform.
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Immediate Ansa Cervicalis-to-Recurrent Laryngeal Nerve Anastomosis for the Management of Recurrent Laryngeal Nerve Infiltration by a Differentiated Thyroid Carcinoma.
ORL, 2020Co-Authors: Wei Wang, Yingna Gao, Shicai Chen, Fei Liu, Caiyun Zhang, Mengjie Chen, Hongliang ZhengAbstract: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.
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the efficacy of Ansa Cervicalis anterior root for unilateral recurrent laryngeal nerve injury
Chinese journal of otorhinolaryngology head and neck surgery, 2018Co-Authors: Yingna Gao, Shicai Chen, Donghui Chen, Wei Wang, Fei Liu, Minhui Zhu, Hongliang ZhengAbstract:Objective To discuss the long-term efficacy of laryngeal reinnervation using the anterior root of the Ansa Cervicalis in the treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Method From January 2010 to January 2016, a total of 39 UVFP patients who underwent Ansa Cervicalis anterior root-to-recurrent laryngeal nerve (RLN) anastomosis and who had suffered nerve disfunction for 6 to 24 months were enrolled as UVFP group.Another 39 age and gender matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and laryngeal electromyography were performed preoperatively and postoperatively for assessing surgery efficacy. Paired sample t test was used for statistical analysis. Result Videostroboscopic reports indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved in the UVFP group (P 0.05, respectively). Both the postoperative GRBAS assessment and acoustic parameters were also significantly improved in the UVFP group, Pre-operative acoustic parameters/Post-operative acoustic parameters were 1.68±0.82/0.39±0.27, 10.08±2.56/4.58±2.96, 0.203±0.216/0.018±0.038, 5.96±1.92/17.42±4.11(P 0.05, respectively). Conclusion Delayed laryngeal reinnervation with the anterior root of Ansa Cervicalis, it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality, which is a feasible and effective approach for the treatment of thyroid surgery-related UVFP. Key words: Recurrent laryngeal nerve; Vocal cord paralysis; Ansa Cervicalis ventral root; Nerve repair
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Bridging gaps between the recurrent laryngeal nerve and Ansa Cervicalis using autologous nerve grafts.
Journal of Voice, 2013Co-Authors: Fei Liu, Donghui Chen, Shicai Chen, Song Shi, Hongliang ZhengAbstract:Summary Objectives/Hypothesis We investigated the clinical efficacy of free nerve grafts in bridging gaps between the recurrent laryngeal nerve (RLN) and Ansa Cervicalis in patients with unilateral RLN injury. Study Design We retrospectively reviewed the charts of 14 patients who underwent relevant free nerve grafting and assessed the clinical outcomes of this procedure. Methods Between January 2000 and January 2010, 14 patients with unilateral vocal fold paralysis were enrolled in this study. In all patients, the RLN was resected and free nerve grafts were applied to bridge the gap between the distal stump of the RLN and the anterior root of Ansa Cervicalis during surgery. Videostroboscopy, acoustic analysis, perceptual evaluation, maximum phonation time (MPT), and laryngeal electromyography (EMG) were performed both preoperatively and postoperatively to assess the clinical outcomes. Results Videostroboscopic findings showed that glottic closure, vocal fold edge, vocal fold position, phase symmetry, and phase regularity were significantly improved postoperatively ( P P P P Conclusions Free nerve grafting is an effective procedure in bridging the gap between the RLN and Ansa Cervicalis in patients with unilateral RLN injury, as well as a safe procedure without obvious morbidity. A satisfactory vocal outcome can be obtained.
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Laryngeal reinnervation using Ansa Cervicalis for iatrogenic unilateral vocal fold paralysis
Chinese Journal of General Surgery, 2012Co-Authors: Wei Wang, Donghui Chen, Shicai Chen, Hongliang ZhengAbstract:Objective To evaluate long-term outcome of laryngeal reinnervation using the main branch of the Ansa Cervicalis for the treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Methods From Oct.1990 to Jan.2010,a total of 325 UVFP patients who underwent main branch of Ansa Cervicalis-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled in the study.We retrospectively analyzed the efficacy of the reinnervation surgery using videostroboscopy,vocal function assessment (acoustic analysis,perceptual evaluation and maximum phonation time ),and laryngeal electromyography. Results Videostroboscopy showed that the glottic closure,vocal fold edge,vocal fold position,phase symmetry and regularity were significantly improved postoperatively. The vocal function parameters (GRBAS scale,jitter,shimmer,noise to harmonics ratio and maximum phonation time) were also significantly improved postoperatively ( P ＜ 0.01 ),as compared to corresponding preoperative values.Voice recovered to a normal level in 93.5％ (304/325)patients,and the effective rate was 98.8％ (321/325). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle. Condusions Laryngeal reinnervation using the main branch of Ansa Cervicalis is a feasible and effective approach for treatment of UVFP patients caused by thyroid surgery,with satisfactory long-term results. Key words: Recurrent laryngeal nerve; Vocal cord paralysis; Thyroidectomy; Reinnervation
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contralateral Ansa Cervicalis to recurrent laryngeal nerve anastomosis for unilateral vocal fold paralysis a long term outcome analysis of 56 cases
Laryngoscope, 2011Co-Authors: Wei Wang, Shicai Chen, Donghui Chen, Siwen Xia, Xiaoxia Qiu, Yuehong Liu, Hongliang ZhengAbstract:Objectives/Hypothesis: To evaluate the long-term efficacy of contralateral Ansa Cervicalis-to-recurrent laryngeal nerve (RLN) anastomosis for unilateral vocal fold paralysis (UVFP), when the Ansa Cervicalis on the side of the paralyzed vocal fold was absent or there was any question about its viability. Study Design: We retrospectively reviewed 56 consecutive cases of delayed laryngeal reinnervation with contralateral Ansa Cervicalis for UVFP. Methods: Between January 1996 and January 2008, a total of 56 UVFP patients were enrolled in this study. All patients underwent contralateral Ansa Cervicalis-to-RLN anastomosis. Videostroboscopy, acoustic analysis, perceptual evaluation and maximum phonation time (MPT), and laryngeal electromyography (LEMG) were performed pre- and postoperatively. Results: Analysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry, and regularity were significantly improved (P < .001, post- vs. preoperative). Perceptual evaluation of dysphonia severity showed that overall grade, roughness, breathiness, asthenia, and strain were also significantly decreased postoperatively (P < .001). Postoperative values of jitter (local), shimmer (local), and mean noise-to-harmonics ratio were significantly lower than the corresponding preoperative values (P < .001). The postoperative MPT value was significantly longer than the preoperative one (P < .001). LEMG showed that there was a significant postoperative improvement in voluntary motor-unit recruitment during phonation (P < .001). Conclusions: In cases with a lack of viable Ansa Cervicalis on the side of a paralyzed vocal fold, contralateral Ansa Cervicalis-to-RLN anastomosis is a feasible and effective approach in the treatment of UVFP and can restore physiologic laryngeal phonatory function.
Shicai Chen - One of the best experts on this subject based on the ideXlab platform.
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Immediate Ansa Cervicalis-to-Recurrent Laryngeal Nerve Anastomosis for the Management of Recurrent Laryngeal Nerve Infiltration by a Differentiated Thyroid Carcinoma.
ORL, 2020Co-Authors: Wei Wang, Yingna Gao, Shicai Chen, Fei Liu, Caiyun Zhang, Mengjie Chen, Hongliang ZhengAbstract: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.
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the efficacy of Ansa Cervicalis anterior root for unilateral recurrent laryngeal nerve injury
Chinese journal of otorhinolaryngology head and neck surgery, 2018Co-Authors: Yingna Gao, Shicai Chen, Donghui Chen, Wei Wang, Fei Liu, Minhui Zhu, Hongliang ZhengAbstract:Objective To discuss the long-term efficacy of laryngeal reinnervation using the anterior root of the Ansa Cervicalis in the treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Method From January 2010 to January 2016, a total of 39 UVFP patients who underwent Ansa Cervicalis anterior root-to-recurrent laryngeal nerve (RLN) anastomosis and who had suffered nerve disfunction for 6 to 24 months were enrolled as UVFP group.Another 39 age and gender matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and laryngeal electromyography were performed preoperatively and postoperatively for assessing surgery efficacy. Paired sample t test was used for statistical analysis. Result Videostroboscopic reports indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved in the UVFP group (P 0.05, respectively). Both the postoperative GRBAS assessment and acoustic parameters were also significantly improved in the UVFP group, Pre-operative acoustic parameters/Post-operative acoustic parameters were 1.68±0.82/0.39±0.27, 10.08±2.56/4.58±2.96, 0.203±0.216/0.018±0.038, 5.96±1.92/17.42±4.11(P 0.05, respectively). Conclusion Delayed laryngeal reinnervation with the anterior root of Ansa Cervicalis, it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality, which is a feasible and effective approach for the treatment of thyroid surgery-related UVFP. Key words: Recurrent laryngeal nerve; Vocal cord paralysis; Ansa Cervicalis ventral root; Nerve repair
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Bridging gaps between the recurrent laryngeal nerve and Ansa Cervicalis using autologous nerve grafts.
Journal of Voice, 2013Co-Authors: Fei Liu, Donghui Chen, Shicai Chen, Song Shi, Hongliang ZhengAbstract:Summary Objectives/Hypothesis We investigated the clinical efficacy of free nerve grafts in bridging gaps between the recurrent laryngeal nerve (RLN) and Ansa Cervicalis in patients with unilateral RLN injury. Study Design We retrospectively reviewed the charts of 14 patients who underwent relevant free nerve grafting and assessed the clinical outcomes of this procedure. Methods Between January 2000 and January 2010, 14 patients with unilateral vocal fold paralysis were enrolled in this study. In all patients, the RLN was resected and free nerve grafts were applied to bridge the gap between the distal stump of the RLN and the anterior root of Ansa Cervicalis during surgery. Videostroboscopy, acoustic analysis, perceptual evaluation, maximum phonation time (MPT), and laryngeal electromyography (EMG) were performed both preoperatively and postoperatively to assess the clinical outcomes. Results Videostroboscopic findings showed that glottic closure, vocal fold edge, vocal fold position, phase symmetry, and phase regularity were significantly improved postoperatively ( P P P P Conclusions Free nerve grafting is an effective procedure in bridging the gap between the RLN and Ansa Cervicalis in patients with unilateral RLN injury, as well as a safe procedure without obvious morbidity. A satisfactory vocal outcome can be obtained.
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Laryngeal reinnervation using Ansa Cervicalis for iatrogenic unilateral vocal fold paralysis
Chinese Journal of General Surgery, 2012Co-Authors: Wei Wang, Donghui Chen, Shicai Chen, Hongliang ZhengAbstract:Objective To evaluate long-term outcome of laryngeal reinnervation using the main branch of the Ansa Cervicalis for the treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Methods From Oct.1990 to Jan.2010,a total of 325 UVFP patients who underwent main branch of Ansa Cervicalis-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled in the study.We retrospectively analyzed the efficacy of the reinnervation surgery using videostroboscopy,vocal function assessment (acoustic analysis,perceptual evaluation and maximum phonation time ),and laryngeal electromyography. Results Videostroboscopy showed that the glottic closure,vocal fold edge,vocal fold position,phase symmetry and regularity were significantly improved postoperatively. The vocal function parameters (GRBAS scale,jitter,shimmer,noise to harmonics ratio and maximum phonation time) were also significantly improved postoperatively ( P ＜ 0.01 ),as compared to corresponding preoperative values.Voice recovered to a normal level in 93.5％ (304/325)patients,and the effective rate was 98.8％ (321/325). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle. Condusions Laryngeal reinnervation using the main branch of Ansa Cervicalis is a feasible and effective approach for treatment of UVFP patients caused by thyroid surgery,with satisfactory long-term results. Key words: Recurrent laryngeal nerve; Vocal cord paralysis; Thyroidectomy; Reinnervation
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contralateral Ansa Cervicalis to recurrent laryngeal nerve anastomosis for unilateral vocal fold paralysis a long term outcome analysis of 56 cases
Laryngoscope, 2011Co-Authors: Wei Wang, Shicai Chen, Donghui Chen, Siwen Xia, Xiaoxia Qiu, Yuehong Liu, Hongliang ZhengAbstract:Objectives/Hypothesis: To evaluate the long-term efficacy of contralateral Ansa Cervicalis-to-recurrent laryngeal nerve (RLN) anastomosis for unilateral vocal fold paralysis (UVFP), when the Ansa Cervicalis on the side of the paralyzed vocal fold was absent or there was any question about its viability. Study Design: We retrospectively reviewed 56 consecutive cases of delayed laryngeal reinnervation with contralateral Ansa Cervicalis for UVFP. Methods: Between January 1996 and January 2008, a total of 56 UVFP patients were enrolled in this study. All patients underwent contralateral Ansa Cervicalis-to-RLN anastomosis. Videostroboscopy, acoustic analysis, perceptual evaluation and maximum phonation time (MPT), and laryngeal electromyography (LEMG) were performed pre- and postoperatively. Results: Analysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry, and regularity were significantly improved (P < .001, post- vs. preoperative). Perceptual evaluation of dysphonia severity showed that overall grade, roughness, breathiness, asthenia, and strain were also significantly decreased postoperatively (P < .001). Postoperative values of jitter (local), shimmer (local), and mean noise-to-harmonics ratio were significantly lower than the corresponding preoperative values (P < .001). The postoperative MPT value was significantly longer than the preoperative one (P < .001). LEMG showed that there was a significant postoperative improvement in voluntary motor-unit recruitment during phonation (P < .001). Conclusions: In cases with a lack of viable Ansa Cervicalis on the side of a paralyzed vocal fold, contralateral Ansa Cervicalis-to-RLN anastomosis is a feasible and effective approach in the treatment of UVFP and can restore physiologic laryngeal phonatory function.
Wei Wang - One of the best experts on this subject based on the ideXlab platform.
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Immediate Ansa Cervicalis-to-Recurrent Laryngeal Nerve Anastomosis for the Management of Recurrent Laryngeal Nerve Infiltration by a Differentiated Thyroid Carcinoma.
ORL, 2020Co-Authors: Wei Wang, Yingna Gao, Shicai Chen, Fei Liu, Caiyun Zhang, Mengjie Chen, Hongliang ZhengAbstract: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.
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the efficacy of Ansa Cervicalis anterior root for unilateral recurrent laryngeal nerve injury
Chinese journal of otorhinolaryngology head and neck surgery, 2018Co-Authors: Yingna Gao, Shicai Chen, Donghui Chen, Wei Wang, Fei Liu, Minhui Zhu, Hongliang ZhengAbstract:Objective To discuss the long-term efficacy of laryngeal reinnervation using the anterior root of the Ansa Cervicalis in the treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Method From January 2010 to January 2016, a total of 39 UVFP patients who underwent Ansa Cervicalis anterior root-to-recurrent laryngeal nerve (RLN) anastomosis and who had suffered nerve disfunction for 6 to 24 months were enrolled as UVFP group.Another 39 age and gender matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and laryngeal electromyography were performed preoperatively and postoperatively for assessing surgery efficacy. Paired sample t test was used for statistical analysis. Result Videostroboscopic reports indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved in the UVFP group (P 0.05, respectively). Both the postoperative GRBAS assessment and acoustic parameters were also significantly improved in the UVFP group, Pre-operative acoustic parameters/Post-operative acoustic parameters were 1.68±0.82/0.39±0.27, 10.08±2.56/4.58±2.96, 0.203±0.216/0.018±0.038, 5.96±1.92/17.42±4.11(P 0.05, respectively). Conclusion Delayed laryngeal reinnervation with the anterior root of Ansa Cervicalis, it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality, which is a feasible and effective approach for the treatment of thyroid surgery-related UVFP. Key words: Recurrent laryngeal nerve; Vocal cord paralysis; Ansa Cervicalis ventral root; Nerve repair
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Laryngeal reinnervation using Ansa Cervicalis for iatrogenic unilateral vocal fold paralysis
Chinese Journal of General Surgery, 2012Co-Authors: Wei Wang, Donghui Chen, Shicai Chen, Hongliang ZhengAbstract:Objective To evaluate long-term outcome of laryngeal reinnervation using the main branch of the Ansa Cervicalis for the treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Methods From Oct.1990 to Jan.2010,a total of 325 UVFP patients who underwent main branch of Ansa Cervicalis-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled in the study.We retrospectively analyzed the efficacy of the reinnervation surgery using videostroboscopy,vocal function assessment (acoustic analysis,perceptual evaluation and maximum phonation time ),and laryngeal electromyography. Results Videostroboscopy showed that the glottic closure,vocal fold edge,vocal fold position,phase symmetry and regularity were significantly improved postoperatively. The vocal function parameters (GRBAS scale,jitter,shimmer,noise to harmonics ratio and maximum phonation time) were also significantly improved postoperatively ( P ＜ 0.01 ),as compared to corresponding preoperative values.Voice recovered to a normal level in 93.5％ (304/325)patients,and the effective rate was 98.8％ (321/325). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle. Condusions Laryngeal reinnervation using the main branch of Ansa Cervicalis is a feasible and effective approach for treatment of UVFP patients caused by thyroid surgery,with satisfactory long-term results. Key words: Recurrent laryngeal nerve; Vocal cord paralysis; Thyroidectomy; Reinnervation
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contralateral Ansa Cervicalis to recurrent laryngeal nerve anastomosis for unilateral vocal fold paralysis a long term outcome analysis of 56 cases
Laryngoscope, 2011Co-Authors: Wei Wang, Shicai Chen, Donghui Chen, Siwen Xia, Xiaoxia Qiu, Yuehong Liu, Hongliang ZhengAbstract:Objectives/Hypothesis: To evaluate the long-term efficacy of contralateral Ansa Cervicalis-to-recurrent laryngeal nerve (RLN) anastomosis for unilateral vocal fold paralysis (UVFP), when the Ansa Cervicalis on the side of the paralyzed vocal fold was absent or there was any question about its viability. Study Design: We retrospectively reviewed 56 consecutive cases of delayed laryngeal reinnervation with contralateral Ansa Cervicalis for UVFP. Methods: Between January 1996 and January 2008, a total of 56 UVFP patients were enrolled in this study. All patients underwent contralateral Ansa Cervicalis-to-RLN anastomosis. Videostroboscopy, acoustic analysis, perceptual evaluation and maximum phonation time (MPT), and laryngeal electromyography (LEMG) were performed pre- and postoperatively. Results: Analysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry, and regularity were significantly improved (P < .001, post- vs. preoperative). Perceptual evaluation of dysphonia severity showed that overall grade, roughness, breathiness, asthenia, and strain were also significantly decreased postoperatively (P < .001). Postoperative values of jitter (local), shimmer (local), and mean noise-to-harmonics ratio were significantly lower than the corresponding preoperative values (P < .001). The postoperative MPT value was significantly longer than the preoperative one (P < .001). LEMG showed that there was a significant postoperative improvement in voluntary motor-unit recruitment during phonation (P < .001). Conclusions: In cases with a lack of viable Ansa Cervicalis on the side of a paralyzed vocal fold, contralateral Ansa Cervicalis-to-RLN anastomosis is a feasible and effective approach in the treatment of UVFP and can restore physiologic laryngeal phonatory function.
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Laryngeal reinnervation using Ansa Cervicalis for thyroid surgery-related unilateral vocal fold paralysis: a long-term outcome analysis of 237 cases.
PLoS ONE, 2011Co-Authors: Wei Wang, Donghui Chen, Shicai Chen, Siwen Xia, Hongliang ZhengAbstract:Objective To evaluate the long-term efficacy of delayed laryngeal reinnervation using the main branch of the Ansa Cervicalis in treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Summary of Background Data UVFP remains a serious complication of thyroid surgery. Up to now, a completely satisfactory surgical treatment of UVFP has been elusive. Methods From Jan. 1996 to Jan. 2008, a total of 237 UVFP patients who underwent Ansa Cervicalis main branch-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled as UVFP group; another 237 age- and gender-matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and electromyography were performed preoperatively and postoperatively. The mean follow-up period was 5.2±2.7 years, ranging from 2 to 12 years. Results Analysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved in the UVFP group (P 0.05, respectively). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle. Conclusions Delayed laryngeal reinnervation with the main branch of Ansa Cervicalis is a feasible and effective approach for treatment of thyroid surgery-related UVFP; it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality.
S Zhou - One of the best experts on this subject based on the ideXlab platform.
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Laryngeal reinnervation for unilateral recurrent laryngeal nerve injuries caused by thyroid surgery
Zhonghua yi xue za zhi, 2002Co-Authors: Hongliang Zheng, Shicai Chen, S Zhou, Yideng Huang, Suqin Zhang, Wu Wen, Yi Cui, Xiaohua Shen, Feng LiuAbstract:Objective To explore the protocols and effects of laryngeal reinnervation for unilateral recurrent laryngeal nerve (RLN) injury caused by thyroid surgery. Methods Different protocols of laryngeal reinnervation were performed upon 29 patients with unilateral recurrent laryngeal nerve injury caused by thyroid surgery, just coming on to with a course of 2 years, including nerve decompression upon 8 cases, end to end anastomosis of recurrent laryngeal nerve upon 6 cases, and anastomosis of main branch of Ansa Cervicalis to recurrent laryngeal nerve upon 15 cases. All were been subjected to preoperative and postoperative voice recording, acoustic analysis, videolaryngoscopy, stroboscopy and electromyography. Results Nerve decompression had restored the normal functional adductory and abductory motion of the vocal cord in 5 patients with a course of less than four months. Although functional motion of vocal cord had not been recovered in three patients who received nerve decompression, 2 being with a course of longer than 4 months and one with a course of less than 4 months, and in all cases who received Ansa Cervicalis anastomosis and end to end anastomosis of recurrent laryngeal nerve, these procedures resulted in medialization of vocal cords except in two cases, one receiving Ansa Cervicalis anastomosis, and the other receiving end to end anastomosis of RLN. Acoustic parameters (Jitter, Shimmer, NNE) measured 6 months after operation of any kind all returned to normal, however, without significant difference among different groups (P0.05). The amplitude of evoked potential of reinnervated laryngeal muscles was significantly greater in the group of nerve decompression than in the group of end to end anastomosis of RLN and group of Ansa Cervicalis anastomosis (both P0.05). However, the amplitude of evoked potential of reinnervated laryngeal muscles between the latter two groups was not significantly different (P0.05). Except in one case in the end to end anastomosis of RLN group and one case in the Ansa Cervicalis anstomosis group, the mass and tension of the reinnervated vocal cord became much the same as the contralateral normal vocal cord and symmetric vibration of the vocal cords and physiological phonation were recovered in all cases. Conclusion (1) Nerve decompression is the best procedure in laryngeal reinnervation. (2) Main branch of Ansa Cervicalis anastomosis and end to end anastomosis of RLN effectively restore the laryngeal vocalization. (3) Selection of the laryngeal reinnervation protocols should depend on the course, severity and type of nerve injury.
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Laryngeal reinnervation for unilateral traumatic recurrent laryngeal nerve injuries
Zhonghua er bi yan hou ke za zhi, 2002Co-Authors: Hongliang Zheng, Shicai Chen, S Zhou, Yideng Huang, Suqin Zhang, Wu Wen, Xiaohua Shen, Feng Liu, Yi CuiAbstract:OBJECTIVE To investigate 5 procedures of laryngeal reinnervation for unilateral vocal cord paralysis induced by traumatic recurrent laryngeal nerve injury. METHODS 35 cases were selected for our study, all patients had unilateral recurrent laryngeal nerve injury, including 8 for nerve decompression, 6 for end to end anastomosis of recurrent laryngeal nerve, 16 for main branch of Ansa Cervicalis anastomosis to recurrent laryngeal nerve, 3 for nerve muscular pedicle and 2 for nerve implantation. All cases have been subjected to preoperative and postoperative voice recording, acoustic analysis, videolaryngoscopy, strobscopy and electromyography. RESULTS It is found the adductory and abductory motion of the vocal cord restored in 5 cases with less than 4 months course who received nerve decompression. Although functional motion of vocal cord was not seen in two patients who received nerve decompression with a course longer than 4 months and one less than 4 months, and in all cases who received Ansa Cervicalis anastomosis and end to end anastomosis of recurrent laryngeal nerve, these procedures resulted in medialization of vocal cord and the mass and tension of the reinnervated vocal cord may become much the same as the contralateral normal vocal cord, thus resuming symmetric vibration of the vocal cords and physiological phonation. Nerve muscular pedicle technique and nerve implantation enabled adductory muscles to be reinnervated, thus improving severe hoarseness, but they didn't restore normal voice. CONCLUSIONS (1) Nerve decompression seems to be the best procedure in laryngeal reinnervation; (2) Main branch of Ansa Cervicalis technique raises satisfactory reinnervation of adductor muscles; (3) Selection of the laryngeal reinnervation protocols should depend on the course, severity and type of nerve injury.
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update laryngeal reinnervation for unilateral vocal cord paralysis with the Ansa Cervicalis
Laryngoscope, 1996Co-Authors: Hongliang Zheng, S Zhou, Zhaoji Li, Y CuanAbstract:Eight patients underwent Ansa Cervicalis anastomosis to the adductor branch of the recurrent laryngeal nerve for unilateral vocal cord paralysis. They were followed long enough (at least 1 year) to determine if the procedure was successful. All cases have been subjected to preoperative and postoperative voice recording, acoustic analysis, and videolaryngoscopy. Some of them have been subjected to stroboscopy and electromyography (EMG). Data from these cases indicate that satisfactory phonatory quality may be achieved after the procedure. The reinnervated vocal cord neither abducted nor adducted, but it presented itself in midline for precise apposition with the normal cord. Synchronous mucosal waves in both vocal cords could be observed. EMG showed that the procedure produced satisfactory reinnervation of the adductory muscles. Therefore, the authors believe that the procedure could be proposed as an alternative to Teflon injection or thyroplasty in selected cases.
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Experimental study on reinnervation of vocal cord adductors with the Ansa Cervicalis.
The Laryngoscope, 1996Co-Authors: Hongliang Zheng, S Zhou, Y Cuan, W Wen, J LanAbstract:The purpose of this study was to reestablish the adduction of the paralyzed vocal cord through reinnervation of the adductor muscles for unilateral vocal cord paralysis. In nine dogs, the adductor branch of the recurrent laryngeal nerve was anastomosed to the main branch of the Ansa Cervicalis. Six months later, various techniques of observation showed that seven of nine cases had excellent to good adduction during whining. Adduction was caused by reinnervation of the adductor muscles from the Ansa Cervicalis as demonstrated by laryngeal spontaneous and evoked electromyography, contraction tension, and various histologic findings. Therefore, the new technique could be a good treatment of unilateral vocal cord paralysis.
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Ansa Cervicalis to the adductor division of the recurrent laryngeal nerve anastomosis for unilateral vocal cord paralysis
Zhonghua er bi yan hou ke za zhi, 1995Co-Authors: Hongliang Zheng, S ZhouAbstract:The main trunk of Ansa Cervicalis was anastomosed to the adductor division of the recurrent laryngeal nerve in seven patients to reinnvervate the vocal cord for unilateral vocal cord paralysis. Although the reinnervated vocal cord neither abducted nor adducted, it presented itself in midline for precise apposition with the nonparalyzed cord. Normal phonatory quality was achieved after the procedure. Electroacoustic analysis indicated that this technique might produce normal phonatory function in paralyzed larynx. Laryngeal electromyography demonstrated that the procedure seemed to induce satisfactory reinnervation of the adductor musculature. Therefore, we think this technique may be recommended as an alternative to Teflon injection or thyroplasty in selected cases.
Y Cuan - One of the best experts on this subject based on the ideXlab platform.
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update laryngeal reinnervation for unilateral vocal cord paralysis with the Ansa Cervicalis
Laryngoscope, 1996Co-Authors: Hongliang Zheng, S Zhou, Zhaoji Li, Y CuanAbstract:Eight patients underwent Ansa Cervicalis anastomosis to the adductor branch of the recurrent laryngeal nerve for unilateral vocal cord paralysis. They were followed long enough (at least 1 year) to determine if the procedure was successful. All cases have been subjected to preoperative and postoperative voice recording, acoustic analysis, and videolaryngoscopy. Some of them have been subjected to stroboscopy and electromyography (EMG). Data from these cases indicate that satisfactory phonatory quality may be achieved after the procedure. The reinnervated vocal cord neither abducted nor adducted, but it presented itself in midline for precise apposition with the normal cord. Synchronous mucosal waves in both vocal cords could be observed. EMG showed that the procedure produced satisfactory reinnervation of the adductory muscles. Therefore, the authors believe that the procedure could be proposed as an alternative to Teflon injection or thyroplasty in selected cases.
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Experimental study on reinnervation of vocal cord adductors with the Ansa Cervicalis.
The Laryngoscope, 1996Co-Authors: Hongliang Zheng, S Zhou, Y Cuan, W Wen, J LanAbstract:The purpose of this study was to reestablish the adduction of the paralyzed vocal cord through reinnervation of the adductor muscles for unilateral vocal cord paralysis. In nine dogs, the adductor branch of the recurrent laryngeal nerve was anastomosed to the main branch of the Ansa Cervicalis. Six months later, various techniques of observation showed that seven of nine cases had excellent to good adduction during whining. Adduction was caused by reinnervation of the adductor muscles from the Ansa Cervicalis as demonstrated by laryngeal spontaneous and evoked electromyography, contraction tension, and various histologic findings. Therefore, the new technique could be a good treatment of unilateral vocal cord paralysis.
