PRIMARY REINNERVATION EFFICIENCY IN PATIENTS WITH LARYNGEAL PARALYSIS IN THYROID SURGERY

AUTHORS:
N. Solomennikova (Kyiv, Ukraine) , V. Palamarchuk (Kyiv, Ukraine) , O. Tovkai (Kyiv, Ukraine) , V. Kuts (Kyiv, Ukraine) , Y. Kozachuk (Kyiv, Ukraine)
Background:
Primary reinnervation of larynx is a physiological method of vocal disorders correction, which is performed simultaneously with thyroid surgery
Methods:
The effectiveness of voice disorders correction various methods was evaluated using a point scale of laryngostroboscopic criteria and spectral voice analysis in 84 patients: 1 group (n=30) -with ansa cervicalis anastomosis - RLN (recurrent laryngeal nerve); 2 group (n=7) -with RLN - RLN anastomosis; 3 group (n=14) - with initial laryngeal paralysis and with ansa cervicalis anastomosis - RLN; 4 group (n=33) - comparison - with laryngeal paralysis after conservative treatment.
Results:
The best voice parameters were observed in 1 group patients (p <0.001). The video laryngostroboscopy score was 5.9±0.2 points. The voice parameters compliance with the reference values: the frequency of the fundamental tone (FFT) - 93.3%, the maximum phonation time (MPT) - 90%, signal /noise ratio (SNR) - 83.3%, Jitter - 83.3%, Shimmer - 83.3%. Patients of the 2nd group: video laryngostroboscopy score 7.9±0.5 points; voice scores compliance with the reference value: FFT - 71.4%, MPT, SNR, Jitter, Shimmer - 42.9%. Patients of group 3: video laryngostroboscopy score of 7.2±1.0 points; compliance of voice scores with the reference value: FFT - 78.6%, MPT and SNR - 42.9%, Jitter, Shimmer - 35.7% (p>0,05).
Conclusions:
Reinnervation by direct anastomosis between the proximal and distal fragments of the RLN is the least effective. The effectiveness of all reinnervation methods compared to the conservative therapy is higher, but it is significantly only in 1 group patients (p <0.001).