Recovery of laryngeal function after intraoperative injury to the recurrent laryngeal nerve
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TLDR
This review aims to provide an update on the current understandings of surgically-induced injury to the laryngeal nerves to clarify any differences between the transient and permanent injury of the RLN.Abstract:
Loss of function in the recurrent laryngeal nerve (RLN) during thyroid/parathyroid surgery, despite a macroscopically intact nerve, is a challenge which highlights the sensitivity and complexity of laryngeal innervation. Furthermore, the uncertain prognosis stresses a lack of capability to diagnose the reason behind the impaired function. There is a great deal of literature considering risk factors, surgical technique and mechanisms outside the nerve affecting the incidence of RLN paresis during surgery. To be able to prognosticate recovery in cases of laryngeal dysfunction and voice changes after thyroid surgery, the surgeon would first need to define the presence, location, and type of laryngeal nerve injury. There is little data describing the events within the nerve and the neurobiological reasons for the impaired function related to potential recovery and prognosis. In addition, very little data has been presented in order to clarify any differences between the transient and permanent injury of the RLN. This review aims, from an anatomical and neurobiological perspective, to provide an update on the current understandings of surgically-induced injury to the laryngeal nerves.read more
Citations
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The Physiologic Impact of Unilateral Recurrent Laryngeal Nerve (RLN) Lesion on Infant Oropharyngeal and Esophageal Performance
Francois D. H. Gould,Andrew R. Lammers,Jocelyn Ohlemacher,Ashley Ballester,Luke Fraley,Andrew Gross,Rebecca Z. German +6 more
TL;DR: The results indicate that RLN lesion leads to increased frequency of aspiration, and increased esophageal dysfunction, with significant variation in these basic patterns at all levels, and suggests that neurological variation underlies this pattern.
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Timing of Nimodipine Therapy for the Treatment of Vocal Fold Paralysis
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Application of transoral continuous intraoperative neuromonitoring in natural orifice transluminal endoscopic surgery for thyroid disease: a preliminary study.
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References
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Journal ArticleDOI
Localization of laryngeal motor neurons in the kitten
TL;DR: In a series of 12 newborn kittens, horseradish peroxidase was used to trace retrograde axoplasmic flow in the motor neurons to laryngeal muscles, and this clear‐cut colorimetric method permitted the localization of theMotor neurons in two nuclei of the ipsilateral brain stem.
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The motor fibers of the recurrent laryngeal nerve are located in the anterior extralaryngeal branch
TL;DR: Great care is needed following the presumed identification of the RLN to ensure there is no unidentified anterior branch, because inadvertent division of a branch may lead to significant vocal cord palsy despite the operator believing the nerve was preserved.
Journal ArticleDOI
The response of central glia to peripheral nerve injury
Mikael Svensson,P. Eriksson,Jonas K. E. Persson,Carl Molander,Jan Arvidsson,Håkan Aldskogius +5 more
TL;DR: Microglial and astroglial cells undergo prompt responses to peripheral motor and sensory axon injury, which include proliferation of microglial cells as well as hypertrophy and increased levels of glial fibrillary acidic protein.
Journal ArticleDOI
Neurologic Disorders of the Larynx
TL;DR: Diseases and treatment: speech therapy for neurologic disorders of the larynx paralysis and paresis of the vocal folds phonosurgery swallowing disorders and aspiration treatment of spasmodic dysphonia (laryngeal dystonia).
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