Role of reinnervation in the management of recurrent laryngeal nerve injury: current state and advances.

PURPOSE OF REVIEW: To present the current state of knowledge concerning different laryngeal reinnervation procedures for unilateral and bilateral vocal palsy.

RECENT FINDINGS: Recent reports show positive outcomes on both unilateral and bilateral reinnervations. The phrenic nerve is the most commonly used donor for bilateral vocal palsy, but use of the superior laryngeal nerve has also been suggested.

SUMMARY: Reinnervation of the larynx is a complex undertaking that can be performed by ENT surgeons with skills in microsurgery. Advances in this this field represent a paradigm shift in laryngeal rehabilitation and a prerequisite for laryngeal transplantation. Advances in basic understanding of nerve regeneration and in particular the need to surgically manage competitive reinnervation make the results of laryngeal reinnervation more predictable.