ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025
Immediate ansa cervicalis-recurrent laryngeal nerve anastomosis promotes multidimensional voice recovery following RLN resection in thyroid cancer.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Post-thyroidectomy anterior neck dysfunction: clinical phenotypes, mechanisms, and comprehensive management.Frontiers in endocrinology · 2026Review
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Abstract
objectiveRecurrent laryngeal nerve (RLN) injury during thyroid surgery is a major cause of postoperative voice dysfunction, particularly in patients with preoperative unilateral vocal cord paralysis (UVCP). This study aimed to evaluate the therapeutic efficacy and safety of immediate ansa cervicalis nerve (ACN)-RLN anastomosis in differentiated thyroid cancer (DTC) surgery, focusing on voice function recovery and procedural impact on oncological outcomes.
methodsA retrospective study analyzed 80 patients with DTC who underwent thyroidectomy between Sept 2017 and Jan 2022. Twenty with RLN invasion received immediate ACN-RLN anastomosis: Group A (UVCP, n = 5) and Group B (normal, n = 15). Sixty without RLN invasion served as controls: Group C (postoperative hoarseness, n = 30) and Group D (no hoarseness, n = 30). Voice outcomes were assessed by videostroboscopy, acoustic parameters (noise-to-harmonics ratio [NHR], jitter, shimmer, maximum phonation time [MPT]), Grade-Roughness-Breathiness (GRB) scale, and Voice Handicap Index-10 (VHI-10) at baseline, 1, and 6 months postoperatively.
resultsACN-RLN anastomosis demonstrated excellent intraoperative safety without increasing blood loss, drainage, or hospital stay. Patients with preoperative UVCP showed significant voice deterioration at 1 month but achieved near-baseline recovery by 6 months. Intervention groups exhibited transient voice impairment compared to controls, with complete recovery by 6 months. Stable voice parameters were maintained in patients without preoperative vocal dysfunction.
conclusionsImmediate ACN-RLN anastomosis is a safe and effective strategy for voice function restoration following RLN resection in thyroid cancer surgery, particularly benefiting patients with preoperative UVCP without compromising oncologic radicality.
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