The surgical treatment of hoarseness due to unilateral recurrent laryngeal nerve palsy

Abstract

We surgically treated 38 patients suffering from hoarseness due to unilateral recurrent laryngeal nerve (RLN) palsy. The surgical methods used included either thyroplasty type I, intracordal collagen injection, arytenoid adduction, or a combination of these. This paper describes the pre- and postoperative phonatory functions while also discussing the indication for each surgical method. Postoperatively, the vocal efficiency index (VEI) improved in all patients, while the mean airflow rate (MFR), the H/N ratio and pitch perturbation did not always show such an improvement. Unsatisfactory results were observed in patients who either had a prominent posterior or a vertical gap between the vocal folds during phonation and who underwent only a single procedure. These findings thus suggested that the selection of the most appropriate surgical method should thus depend on the position and degree of atrophy in the paralyzed vocal fold. In addition, the patient's age, degree of social activity and personal desire to obtain an improvement in their condition were also considered to be important factors.