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World Journal of Surgery

, Volume 6, Issue 3, pp 342–346 | Cite as

Recurrent laryngeal nerve anastomosis following thyroid surgery

  • Haruo Ezaki
  • Hiroki Ushio
  • Yasuo Harada
  • Nobuo Takeichi
Original Scientific Reports

Abstract

End-to-end anastomosis of the recurrent laryngeal nerve had been abandoned because movement of the vocal cords could not be restored because of misdirected regeneration. However, the authors discovered that, although vocal cord movement could not be restored, phonation was better in those in whom the recurrent laryngeal nerve was anastomosed than in those in whom it had been left in the severed state. Hoarseness improves after nerve anastomosis because it prevents vocal cord atrophy and the vocal cord gap is smaller. End-to-end anastomosis of the recurrent laryngeal nerve is, therefore, considered to be of value.

Keywords

Public Health Vocal Cord Recurrent Laryngeal Nerve Laryngeal Nerve Cord Movement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

L'anastomose termino-terminale du nerf récurrent après blessure chirurgicale a été abandonnée en raison de l'échec de la régénération par la majorité des chirurgiens.

Les auteurs ont remarqué cependant que si les mouvements des cordes vocales ne peuvent être rétablis la tentative de restoration de la continuité du nerf donne de meilleurs résultats que l'abandon des deux extrémités sectionnées.

La raucité de la voix s'améliore après la tentative d'anastomose parce qu'elle prévient l'atrophie de la corde vocale.

L'anastomose termino-terminale après blessure du nerf laryngé inférieur mérite donc d'être toujours tentée.

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References

  1. 1.
    Ushio, H.: Clinical and experimental studies on re-current laryngeal nerve paralysis. Part 1, Clinical aspects. J. Jpn. Surg. Soc.82:22, 1980Google Scholar
  2. 2.
    Gacek, R.R., Lyon, M.J.: Fiber components of the recurrent laryngeal nerve in the cat. Ann. Otol.85:460, 1976Google Scholar
  3. 3.
    Gacek, R.R., Malmgren, L.T., Lyon, M.J.: Localization of adductor and abductor motor nerve fibers to the larynx. Ann. Otol.86:770, 1977Google Scholar
  4. 4.
    Malmgren, L.T., Lyon, M.J., Gacek, R.R.: Localization of abductor and adductor fibers in the kitten recurrent laryngeal nerve: Use of a variation of the horseradish peroxidase tracer technique. Exp. Neurol.55:187, 1977Google Scholar
  5. 5.
    Tashiro, T.: Experimental studies on the reinnervation of larynx after accurate neurorrhaphy. Laryngoscope82:225, 1972Google Scholar
  6. 6.
    Tomita, H.: An electromyographic study of recurrent laryngeal nerve paralysis. (Jpn. J.) Otol.70:963, 1967Google Scholar
  7. 7.
    Nagashima, T.: An experimental study of recurrent laryngeal nerve paralysis. Electromyography versus morphological findings. (Jpn. J.) Otologia16:124, 1970Google Scholar
  8. 8.
    Hirano, M., Tomita, H., Nagashima, T., et al.: Paradoxical movement of vocal cords in recurrent laryngeal nerve paralysis. (Jpn. J.) Otol.73:885, 1970Google Scholar
  9. 9.
    Horsley, J.S: Suture of the recurrent laryngeal nerve with report of a case. Trans. South. Surg. Gynecol. Assoc.22:161, 1909Google Scholar
  10. 10.
    Doyle, P.J., Brammeff, R.E., Eveerts, E.G.: Result of surgical section and repair of the recurrent laryngeal nerve. Laryngoscope99:1245, 1967Google Scholar
  11. 11.
    Blalock, A., Crowe, S.J.: Recurrent laryngeal nerve in dogs; experimental studies. Arch. Surg.12:95, 1926Google Scholar
  12. 12.
    Lahey, F.H.: Structure of the recurrent laryngeal nerve for bilateral abductor paralysis. Ann. Surg.87:481, 1928Google Scholar
  13. 13.
    Ushio, H.: Clinical and experimental studies on recurrent nerve paralysis. Part 2, Experimental aspects. J. Jpn. Surg. Soc. (in press)Google Scholar
  14. 14.
    Siribodhi, C., Sundmaker, W.: Electromyographic studies of laryngeal paralysis and regeneration of laryngeal motor nerves in dogs. Laryngoscope73:148, 1963Google Scholar
  15. 15.
    Hiroto, I., Hirano, M., Tomita, H.: Electromyographic investigation of human vocal cord paralysis. Ann. Otol.77:296, 1968Google Scholar
  16. 16.
    Ohyama, M., Ueda, N., Harvey, J.E., et al.: Electrophysiologic study of reinnervated laryngeal motor unit. Laryngoscope82:237, 1972Google Scholar
  17. 17.
    Satoh, I., Harvey, J.H., Ogura, J.H.: Impairment of function of the intrinsic laryngeal muscles after regeneration of the recurrent laryngeal nerve. Laryngoscope84:53, 1974Google Scholar
  18. 18.
    Gordon, J.H., McCabe, B.F.: The effect of accurate neurorraphy on reinnervation and return of laryngeal function. Laryngoscope78:236, 1968Google Scholar
  19. 19.
    Boles, R., Fritzel, B.: Injury and repair of the recurrent laryngeal nerves in dogs. Laryngoscope79:1405, 1969Google Scholar

Copyright information

© Société Internationale de Chirurgie 1982

Authors and Affiliations

  • Haruo Ezaki
    • 1
  • Hiroki Ushio
    • 1
  • Yasuo Harada
    • 1
  • Nobuo Takeichi
    • 1
  1. 1.Second Department of Surgery and Department of OtolaryngologyHiroshima University School of MedicineHiroshimaJapan

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