A Long-term Comparative Prospective Study Between Reinnervation and Injection Laryngoplasty

Abstract

Objectives: This study compared and assessed long-term voice outcomes when thyroidectomy-related unilateral vocal fold paralysis (VFP) was managed using injection laryngoplasty (IL) and recurrent laryngeal nerve reinnervation (RLNR). Study Design: Prospective clinical study. Methods: A prospective clinical trial was performed from March 2005 to January 2016 at Soonchunhyang University Bucheon Hospital (Bucheon, South Korea). Nineteen patients who underwent ansa cervicalis to RLNR or direct reinnervation, and 43 patients who underwent IL to treat thyroidectomy-related unilateral VFP, were enrolled. Results: All voice parameters exhibited statistically significant improvement 12 months post-IL, which persisted for 24 and 36 months (P < 0.05). However, at 36 months post-IL, some voice parameters had deteriorated relative to the values at 24 months post-IL. After RLNR, all voice parameters exhibited statistically significant improvement after 12 months, and the improvements remained stable until 36 months postsurgery without deterioration of voice parameters (P < 0.05). At 36 months, RLNR provided better voice results than IL (P < 0.05). Conclusion: Both RLNR and IL yielded statistically significant voice improvements at 36 months postoperatively. However, after 36 months, RLNR provided better results than IL.