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Hussam K. El-Kashlan, MD; William R. Carroll, MD; Norman D. Hogikyan, MD; Douglas B. Chepeha, MD; Paul R. Kileny, PhD; Ramon M. Esclamado, MD

Arch Otolaryngol Head Neck Surg. 2001;127:1211-1215.

Objective  To determine if selective reinnervation of the cricothyroid muscle could be achieved with muscle-nerve-muscle neurotization.

Design  Case series.

Setting  Tertiary referral center.

Patients  Three consecutive patients with high vagal lesions that resulted in unilateral laryngeal paralysis.

Interventions  Patients underwent laryngeal reinnervation with ansa hypoglossi to recurrent laryngeal nerve anastomosis. In addition, patients underwent selective cricothyroid muscle reinnervation by muscle-nerve-muscle neurotization technique.

Main Outcome Measures  Objective and subjective improvement in voice quality and electromyographic evidence of selective reinnervation of the cricothyroid muscle.

Results  All patients recovered normal or near-normal speaking voice and had normal objective measures of voice quality. They also showed electromyographic evidence of cricothyroid muscle reinnervation.

Conclusion  The muscle-nerve-muscle neurotization technique was successful in providing selective reinnervation of the cricothyroid muscle in our 3 patients.

From the Departments of Otolaryngology, University of Michigan, Ann Arbor (Drs El-Kashlan, Hogikyan, Chepeha, and Kileny), University of Alabama at Birmingham (Dr Carroll), and Cleveland Clinic Foundation, Cleveland, Ohio (Dr Esclamado).