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Decision Making Around Reinnveration

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Decision Making in Vocal Fold Paralysis

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Abstract

Unilateral vocal fold paralysis (UVFP) occurs after injury to the laryngeal nerves and is associated with significant patient morbidity including dysphonia and aspiration. For patients with UVFP, surgical options to help address the symptoms of glottic insufficiency include multiple types of static or framework procedures and laryngeal reinnervation. The principal advantage of reinnervation over static procedures is improvement in vocal fold pliability and tone. However, reinnervation takes several months before improvements can be fully appreciated, which can make the immediate benefits from static procedures particularly attractive. This chapter details the clinical decision-making surrounding laryngeal reinnervation in patients with unilateral vocal fold paralysis. General principals of reinnervation, preoperative evaluation, laryngeal reinnervation techniques, and surgical considerations are highlighted. Published studies show that laryngeal reinnervation is a useful procedure for treating select patients with unilateral vocal fold paralysis. A detailed understanding of laryngeal reinnervation, including patient factors, surgical techniques, post-operative outcomes, advantages, and drawbacks, can help to most effectively counsel and treat patients with vocal fold paralysis.

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Authors and Affiliations

  1. Department of Otolaryngology – Head and Neck Surgery, Barnes Jewish Hospital/Washington University School of Medicine, Saint Louis, MO, USA

    Neel K. Bhatt

  2. Division of Laryngology & Professional Voice, Department of Otolaryngology & Professional Voice, Medical College of Wisconsin, Milwaukee, WI, USA

    Joel H. Blumin

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  1. Neel K. Bhatt
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Correspondence to Neel K. Bhatt .

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Editors and Affiliations

  1. NYU Swallowing Disorders Center, New York University, New York, NY, USA

    Milan R. Amin

  2. USC Voice Center, University of Southern California, Los Angeles, CA, USA

    Michael M. Johns

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Bhatt, N.K., Blumin, J.H. (2019). Decision Making Around Reinnveration. In: Amin, M., Johns, M. (eds) Decision Making in Vocal Fold Paralysis. Springer, Cham. https://doi.org/10.1007/978-3-030-23475-1_10

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