Selective cricothyroid muscle reinnervation by muscle-nerve-muscle neurotization

Objective: To determine if selective reinnervation of the cricothyroid musc le could be achieved with muscle-nerve-muscle neurotization. Design: Case series. Setting: Tertiary referral center. Patients: Three consecutive patients with high vagal lesions that resulted in unilateral laryngeal paralysis. Interventions: Patients underwent laryngeal reinnervation with ansa hypoglo ssi to recurrent laryngeal nerve anastomosis. In addition, patients under-w ent selective cricothyroid muscle reinnervation by muscle-nerve-muscle neur otization technique. Main Outcome Measures: Objective and subjective improvement in voice qualit y and electromyographic evidence of selective reinnervation of the cricothy roid muscle. Results: All patients recovered normal or near-normal speaking voice and ha d normal objective measures of voice quality. They also showed electromyogr aphic evidence of cricothyroid muscle reinnervation. Conclusion: The muscle-nerve-muscle neurotization technique was successful in providing selective reinnervation of the cricothyroid muscle in our 3 pa tients.