Allograft Nerve Repair of a Transected Recurrent Laryngeal Nerve with Voice and Singing Recovery

Figure 2: Laryngoscope image of the patient presented. (A) Vocal cords relaxed with the patient at rest. (B) Vocal cords closed with a well-mediatized left vocal cord and complete glottic closure on stroboscopy.

Immediately postoperatively, the patient demonstrated a hoarse voice and an inability to sing. At three months post-operatively, she was seen in the otolaryngology clinic for laryngoscopy, which revealed left vocal cord immobility with right vocal cord compensation. At nine months follow-up, the patient reported she had a complete return to her normal speaking voice with imperceptible hoarseness and a laryngoscopy demonstrating a well-medialized left vocal cord with complete glottic closure on stroboscopy (Figure 2).

CONCLUSIONS

The RLN is critical to voice and vocal cord function, and when primary repair is not possible, an interposition acellular nerve allograft may be a safe and effective solution. In this case, voice tone had improved, and vocal cord position was more favorable after nerve repair with nerve allograft reconstruction.