2012 Volume 63 Issue 6 Pages 460-465
We experienced a case in which thyroid papillary carcinoma invaded the recurrent laryngeal nerve (RLN) and we were obliged to perform reinnervation of the RLN in the larynx. The case was a female 86 years of age. Her major complaints at initial visit were cervical swelling, hoarseness and cough. We confirmed a tumor which occupied the left lobe of the thyroid, and the left vocal cord was fixed. The result of FNA was a suspected class V papillary Ca, and we performed left lobectomy and D1 dissection. We were unable to find the peripheral end of the RLN out of the larynx because of invasion, so we cut part of the thyroid cartilage, found the peripheral end of the RLN inside the larynx, and performed reinnervation with a cervical loop. Gradually the tonus of her vocal cord is increasing and her phonetic condition is improving. In cases when we are unable to find the peripheral end of the RLN out of the larynx, attempting to find it in the larynx was considered an effective method, in addition to secondary phonosurgery such as laryngoplasty.
