Laryngeal reinnervation with nerve-nerve anastomosis versus laryngeal framework surgery alone: a comparison of safety.

OBJECTIVE

To characterize any additional risks and rate of complication associated with laryngeal reinnervation in comparison to traditional laryngeal framework surgery.

DESIGN

Retrospective chart review over a 5-year period.

RESULTS

A total of 16 reinnervation procedures were performed to rehabilitate a paralyzed vocal fold. Of the 16 procedures, 12 (75%) were combined with arytenoid adduction. One reinnervation was aborted due to presence of scar and vascular malformation in the tracheal-esophageal groove. There were no major complications (airway obstruction or death). There were no cases of prolonged dysphagia or aspiration pneumonia; there was one wound infection (6%). Endoscopic findings postoperatively included pharyngeal ecchymoses in three patients (19%), all of whom underwent a simultaneously performed arytenoid adduction. There was a similar incidence of minor complications in traditional framework surgery performed without reinnervation (P > 0.05).

CONCLUSION

Laryngeal reinnervation, alone or in combination with laryngeal framework surgery, does not appear to add significant perioperative morbidity. This is the first report to document the safety of laryngeal reinnervation by nerve-nerve anastomosis.