Vagus-recurrent nerve anastomosis for vocal cord paralysis associated with the surgical treatment of thoracic malignancies

Abstract

Five patients with advanced lung cancer and one with malignant pleural mesothelioma developed recurrent laryngeal nerve palsy, owing to resection of the intrathoracic vagus nerve along with the complete removal of malignancies. They showed hoarseness, short phonation, and/or swallowing disorder, which were major factors worsening their quality of life. We performed direct anastomosis of the vagus to the recurrent laryngeal nerve at the level of the hypopharynx to improve these phonetic and swallowing impairments 2 to 5 months after the thoracic operation.
Three to six months after the nerve anastomosis, all patients except one with relapse of mesothelioma had achieved sufficient improvement in phonation and swallowing.