Abstract

Since October 1983, we have experienced 30 surgical treatments for unilateral and bilateral recurrent laryngeal nerve paralysis. As dynamic reconstruction, 7 cases underwent free nerve grafting, 5 pedicled nerve muscle grafting, and 1 end-to-end anastomosis. Recovery of the vocal cord mobility was not seen in all cases. But they were free from atrophy of the vocal cords, which proves the efficiency of the treatments in prevention of vocal cord atrophy. In 69% of the cases, the maximum phonation times (MPT) were kept more than 10 seconds in the long time followings. As static reconstruction, 11 cases underwent thyroplasty type I (Isshiki), and 2 cases underwent intracordal silicone injection. Fifty percent of them obtained MPT more than 10 seconds after operations. In cases of bilateral paralysis, we used a one-way valve cannula (KOKEN) to keep both good phonation and safety respiration.