J.Jpn. Surg. Soc.. 83(6): 507-514, 1982

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Original article

CLINICAL AND EXPERIMENTAL STUDIES ON RECURRENT LARYNGEAL NERVE PARALYSIS
Part II. Experimental Study Electromyographic Studies on Neurorrhaphy of Recurrent Laryngeal Nerve

Even though vocal cord movement cannot be restored, it was found that hoarseness was slighter if end-to-end anastomosis of the recurrent laryngeal nerve was performed rather than when left in severed state. To clarify this phenomenon, an unilateral recurrent laryngeal nerve of mongrel adult dog was severed and immediately anastomosed end-to-end. Vocal cord movement in 7 dogs that survived for more than one year was studied by electromyograms of their intrinsic laryngeal muscles.
The anastomosed group was found to be superior to the non-anastomosed group in the following.
1. Electromyograms of the anastomosed group indicated misdirected regeneration of nerves could not be avoided, but the coexistence of normal regeneration was observed. Although there was no vocal cord movement at the time of phonation, mucosal wave movement of the vocal cords could yield by the tension of the intrinsic laryngeal muscle. It is felt this tension reduces hoarseness.
2. Intrinsic laryngeal muscle atrophy was prevented in the anastomosed group, and thus the gap between bilateral vocal cords at the time of phonation was small. This small gap is also considered to contribute to the reduction of hoarseness.

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