Our Summary

This research paper is a review of studies on the use of surgical reinnervation in children with one-sided (unilateral) or two-sided (bilateral) vocal fold paralysis. The researchers looked at the age, gender, surgical technique, and the results before and after the operation for these patients. They searched major medical databases for all relevant studies to date.

In total, they analyzed 19 studies involving 179 patients who underwent this surgery, the youngest of which was just under 2 years old. The most common cause of vocal fold paralysis in these cases was injury to a particular nerve during surgery (especially during a procedure to close a blood vessel present at birth that normally closes on its own shortly after birth).

The results showed that this surgical procedure significantly improved both the patients’ voice and ability to swallow. Specifically, a scoring system used to evaluate voice disorder severity showed a significant improvement, as did a measure of the longest time a patient could sustain a vowel sound.

No major complications were reported in these studies. So the researchers conclude that surgical reinnervation appears to be a safe and effective treatment for children with one-sided or two-sided vocal fold paralysis. It seems to improve the voice and swallowing, and also improves related quality of life measures.

FAQs

  1. What is surgical reinnervation and who is it used for?
  2. What were the results found in the studies regarding vocal fold paralysis treatment with surgical reinnervation?
  3. Were there any reported complications from the surgical reinnervation procedure in the studies?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vocal cord surgery is to follow all post-operative care instructions carefully, including voice rest, avoiding yelling or whispering, and attending all follow-up appointments. It is important to give your vocal cords time to heal properly so that you can achieve the best results from the surgery. Additionally, practicing good vocal hygiene, such as staying hydrated and avoiding irritants like smoking, can help maintain the health of your vocal cords in the long term.

Suitable For

Patients who are typically recommended vocal cord surgery are those with one-sided or two-sided vocal fold paralysis, especially those who have suffered injury to a nerve during surgery. This surgery is most commonly performed in children, with the youngest patients being just under 2 years old. The procedure has been shown to significantly improve voice and swallowing function in these patients, with no major complications reported in the studies analyzed. Overall, surgical reinnervation appears to be a safe and effective treatment option for patients with vocal cord paralysis.

Timeline

Before vocal cord surgery, a patient may experience symptoms such as hoarseness, difficulty speaking or singing, breathiness, and even trouble swallowing. These symptoms can have a significant impact on a patient’s quality of life and ability to communicate effectively.

After vocal cord surgery, patients typically experience a period of recovery and rehabilitation. This may involve voice therapy to help improve vocal function and strengthen the muscles surrounding the vocal cords. Patients may also need to follow specific post-operative care instructions to ensure proper healing and prevent complications.

Over time, patients may notice improvements in their voice quality, ability to speak or sing, and swallowing function. The surgery aims to restore vocal cord function and improve overall vocal performance. In the case of surgical reinnervation for vocal fold paralysis, studies have shown significant improvements in voice quality and swallowing ability following the procedure. Overall, vocal cord surgery can have a positive impact on a patient’s quality of life and ability to communicate effectively.

What to Ask Your Doctor

Questions a patient should ask their doctor about vocal cord surgery may include:

  1. What is the specific reason for recommending vocal cord surgery in my case?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery period expected to be, and what can I expect during the recovery process?
  4. Will I need to undergo any additional therapy or treatments after the surgery?
  5. What are the expected outcomes of the surgery in terms of improving my voice and swallowing abilities?
  6. Are there any alternative treatments or procedures that could be considered instead of surgery?
  7. How experienced are you in performing this type of surgery, and what is your success rate with similar cases?
  8. How will my voice and swallowing be assessed before and after the surgery to track improvements?
  9. Are there any lifestyle changes or precautions I need to take after the surgery to ensure the best possible outcome?
  10. Are there any specific guidelines or instructions I need to follow leading up to the surgery to prepare for it?

Reference

Authors: Hoey AW, Hall A, Butler C, Frauenfelder C, Wyatt M. Journal: Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5771-5781. doi: 10.1007/s00405-022-07471-y. Epub 2022 Jul 15. PMID: 35838782