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CASE STUDY
COURSE OF LARYNGEAL FUNCTION RECOVERY AFTER RECONSTRUCTION OF THE LARYNGEAL NERVES
1
Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Poland
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Publication date: 2020-03-31
Corresponding author
Paulina Krasnodębska
Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, 17 Mokra St., Poland; email: p.krasnodebska@ifps.org.p, tel. +48 223 650 351
Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, 17 Mokra St., Poland; email: p.krasnodebska@ifps.org.p, tel. +48 223 650 351
J Hear Sci 2020;10(1):51–56
KEYWORDS
TOPICS
ABSTRACT
Background:
According to the literature, the rate of laryngeal paralysis after thyroid surgery is as high as several percent. For oncolog-ical operations the rate can reach 20%. The return of laryngeal function depends on the degree of nerve damage. Surgical procedures are required to increase the likelihood of nerve function recovery. Three methods of phonosurgery are currently used. The first is based on injecting auto or alloplastic materials into the vocal fold. The second interferes with the skeleton of the laryngeal cartilages; according to the Isshiki clas-sification, it includes type I thyreoplasty (medialisation thyreoplasty), optionally with complementary arytenoid adduction. The third method reconstructs the laryngeal nerves. Combinations of the three methods are increasingly used. Conservative treatment including phoniatric voice rehabilitation should be started as early as possible.
Case report:
The paper presents a case report of a patient after thyroid surgery due to papillary carcinoma, complicated by bilateral laryn-geal paralysis and aphonia.
Conclusions:
Functional Voice Therapy started just after healing of the postoperative wound in the neck eliminated abnormal compensatory mechanisms of phonation. Reconstruction of the laryngeal nerves is an opportunity to quickly return laryngeal function and prevents unwanted secondary functional mechanisms within the vocal organ.
According to the literature, the rate of laryngeal paralysis after thyroid surgery is as high as several percent. For oncolog-ical operations the rate can reach 20%. The return of laryngeal function depends on the degree of nerve damage. Surgical procedures are required to increase the likelihood of nerve function recovery. Three methods of phonosurgery are currently used. The first is based on injecting auto or alloplastic materials into the vocal fold. The second interferes with the skeleton of the laryngeal cartilages; according to the Isshiki clas-sification, it includes type I thyreoplasty (medialisation thyreoplasty), optionally with complementary arytenoid adduction. The third method reconstructs the laryngeal nerves. Combinations of the three methods are increasingly used. Conservative treatment including phoniatric voice rehabilitation should be started as early as possible.
Case report:
The paper presents a case report of a patient after thyroid surgery due to papillary carcinoma, complicated by bilateral laryn-geal paralysis and aphonia.
Conclusions:
Functional Voice Therapy started just after healing of the postoperative wound in the neck eliminated abnormal compensatory mechanisms of phonation. Reconstruction of the laryngeal nerves is an opportunity to quickly return laryngeal function and prevents unwanted secondary functional mechanisms within the vocal organ.
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