RLN Paralysis - Update on Reinnervation and Neurostimulation

In unilateral vocal fold paralysis with signs of thyroarytenoid muscle atrophy and wide glottical gap an early non-selective reinnervation with ansa cervicalis nerve transfer may reduce the need for laryngeal framework surgery afterwards.

For bilateral vocal fold paralysis therapeutic options with at least partial motion repair should be more emphasized in future. There is a recently progress in the concepts of selective reinnervation and neurostimulation/pacing. These new therapies have the potential to restore near normal respiratory function without compromising voice and swallowing and may contribute to the development of larynx transplantation surgery.