PHYSIOLOGICAL MOTION AFTER LARYNGEAL NERVE REINNERVATION - A NEW METHOD

In this study a new method of reinnervation for unilateral recurrent l aryngeal nerve paralysis was performed in canines, producing physiolog ic vocal fold motion in each of a small series of animals. During the procedure the left anterior division of the recurrent laryngeal nerve was reinnervated with axons from the thyroarytenoid branch of the cont ralateral recurrent laryngeal nerve. The posterior branch of the left recurrent laryngeal nerve was divided and sutured to the ansa cervical is to maintain tone in the posterior cricoarytenoid muscle. In all fou r animals, the right distal vocalis stump was reinnervated with an ans a cervicalis nerve branch. After 3 months physiologic vocal fold motio n and electromyographic activity could be demonstrated during mechanic al stimulation of the supraglottis (adduction) and during tracheostomy obstruction (abduction). Acoustic data revealed improvement of jitter , shimmer, signal-to-noise ratio, and vocal efficiency in reinnervated animals compared with paralyzed canines before treatment, although th e results lacked statistical significance. This approach to the rehabi litation of unilateral vocal fold paralysis is discussed.