양측 성대 마비의 치료

Management of bilateral vocal fold paralysis: reinnervation

Laryngeal reinnervation has been investigated as a treatment option for bilateral vocal fold paralysis (BVFP) that can restore laryngeal function while preserving laryngeal anatomy. Traditionally, BVFP treatment involves irreversible structural changes to the larynx, such as tracheostomy, arytenoidectomy, or cordectomy, which often result in impaired voice and swallowing. In contrast, laryngeal reinnervation aims to restore laryngeal muscle tone and function by providing new neural input to the paralyzed larynx. Reinnervation techniques can be broadly categorized into non-selective and selective methods. Non-selective reinnervation, such as recurrent laryngeal nerve (RLN) end-to-end anastomosis or ansa cervicalis-to-RLN anastomosis, primarily focuses on maintaining muscle bulk and tone. Selective reinnervation techniques, including nerve-muscle pedicle with the ansa cervicalis, selective reinnervation using the phrenic nerve, and bilateral selective laryngeal reinnervation, aim to restore both abduction and adduction function of the larynx. This review summarizes the current laryngeal reinnervation techniques for BVFP treatment.