Clinical Observation of End-To-End Neuroanastomosis in the Treatment of Complete Injury of the Unilateral Recurrent Laryngeal Nerve

Abstract

Background: Complete injury of the recurrent laryngeal nerve (RLN) is a serious complication of thyroidsurgery. Increasingly researches focus on the voice recovery of patients with RLN injury. This paper studiedthe effect of immediate end-to-end neuroanastomosis after complete injury of the unilateral RLN duringthyroid surgery on postoperative vocal function.Methods: Thirteen patients who underwent end-to-end neuroanastomosis for the treatment of completeinjury of the unilateral RLN caused by thyroid surgery in Hunan Provincial People’s Hospital betweenOctober 2009 and January 2020 were selected. The basic information, cause of RLN injury, postoperativevoice recovery, recovery time, and subjective assessment of voice by auditory perception results (Grade,Roughness, Breathiness, Asthenia, and Strain, the GRBAS score) of the patients were recorded.Results: Among the 13 cases with RLN injury, the cause of RLN injury in 10 cases was transection bysharp instruments, and the voice was recovered one day after the operation. The cause of RLN injury inone case was suture of the RLN branch, and the voice was recovered one day after the operation. Thecause of RLN injury in two cases was thermal injury, and the times for voice recovery after end-to-endneuroanastomosis were 3 and 4 months. The patients with a GRBAS score of 0 or 1 recovered their voiceone day after the operation. The GRBAS score reached 1 in the two thermal injury cases, with voice recoveryat 3 and 4 months after surgery. By 6 months, the voice recovery rate of the patients was 100%.Conclusions: After complete injury of the unilateral RLN, immediate end-to-end anastomosis of theRLN can maximally preserve the postoperative vocal function of patients.