Long-term preservation of voice improvement following surgical medialization and reinnervation for unilateral vocal fold paralysis

In June of 1996, we reported improved functional voice results when reinner vation was combined with surgical medialization for unilateral vocal fold p aralysis.' In addition, it was noted that further wasting of the reinnervat ed vocal fold was prevented in 96% of these patients beyond 2 years' follow up. The study reported here compares the long-term preservation of voice im provement achieved by surgical medialization alone with that resulting from combined medialization and nerve-muscle pedicle reinnervation. Further sig nificant wasting of the paralyzed vocal fold with voice deterioration from that achieved by surgical medialization alone was noted between 6 months an d 2 years postoperatively in 28% of patients, while only 4% of those underg oing combined reinnervation demonstrated this finding at a minimum of 2 yea rs' follow-up.