Abstract
Background Recurrent laryngeal nerve (RLN) injury carries significant morbidity. Microsurgical
repair of the RLN has proven promising for enhancing patient recovery of vocal function;
however, data remains limited.
Methods This retrospective cohort study included patients who underwent RLN repair from 2007
to 2022. Demographics and medical history were collected. The location and etiology
of RLN injury, as well as the repair technique, were collected. Follow-up data were
collected at the initial postoperative visit, at 6 months and at 1 year. Hoarseness
was classified as mild, moderate, or severe. Of patients who underwent nasopharyngolaryngoscopy
(NPL) following repair, the glottic gap was measured. Vocal interventions performed
were also recorded. This study utilized descriptive statistical methods.
Results Eleven patients underwent RLN repair. All patients underwent immediate repair. Fifty-four
percent (n = 6) of RLN injuries resulted from tumor inflammation or nerve encasement. Eighty-two
percent (n = 9) underwent direct RLN coaptation, 9% (n = 1) underwent vagus-RLN anastomosis, and 9% (n = 1) underwent an interposition nerve graft. Technical success was 100%. Seventy-three
percent (n = 8) required otolaryngology referral, and of those, 50% (n = 4) required intervention. At initial evaluation, 91% (n = 10) suffered from mild to severe hoarseness, and of patients who underwent NPL,
all had a glottic gap. At 1 year, 82% of patients (n = 9) improved to having mild to no appreciable hoarseness. Of the patients who underwent
NPL, 62% (n = 5) had closure of the glottic gap.
Conclusion Patients undergoing repair of the RLN following injury showed excellent recovery
of vocal function and resolution of glottic gap at 1 year.
Keywords
laryngeal nerve - nerve repair - thyroid
