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Pertl, L; Zacherl, J; Mancusi, G; Gächter, JN; Asari, R; Schoppmann, S; Bigenzahn, W; Schneider-Stickler, B.
High risk of unilateral recurrent laryngeal nerve paralysis after esophagectomy using cervical anastomosis.
Eur Arch Otorhinolaryngol. 2011; 268(11):1605-1610 Doi: 10.1007/s00405-011-1679-7
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Posch-Pertl Laura
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Abstract:
The goal of this study was to estimate the incidence of temporary and permanent unilateral recurrent laryngeal nerve paralysis (URLNP) after esophagectomies with cervical anastomosis and to determine the impact of surgical technique, tumor type, tumor localization and age on the incidence of URLNP. From March 2002 to November 2009, 84 patients underwent a laryngoscopical evaluation before and after esophagectomy with cervical anastomosis prospectively. If the postoperative URLNP recovered within 6 months, the paresis was classified as transient; if not, it was defined as permanent. The results indicate that the overall incidence of postoperative URLNP was 50% (42/84). Twenty-four of the 84 patients (28.6%) showed a transient URLNP. A permanent URLNP was observed in 9 of the 84 patients (10.7%). The remaining 9 of the 84 patients (10.7%) were categorized as paresis with unknown clinical outcome due to missing follow-up. There were significantly more postoperative URLNPs in the group operated by transthoracic esophagectomy than by transhiatal esophagectomy (p < 0.001). Multifocal tumors and those localized suprabifurcational showed a higher incidence of postoperative URLNP than unifocal lesions with infrabifurcational localization (p = 0.046). Histological type of tumor and patients' age had no impact on URLNP. The high incidence of URLNP in our study underlines the high risk of URLNP after esophagectomy with cervical anastomosis, and consequently the importance of routine laryngoscopic pre- and postoperative evaluation of the vocal fold motility.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Aged, 80 and over -
Anastomosis, Surgical - adverse effects
Anastomosis, Surgical - epidemiology
Deglutition -
Esophageal Neoplasms - surgery
Esophagectomy - adverse effects Esophagectomy - methods
Esophagus - physiopathology Esophagus - surgery
Follow-Up Studies -
Humans -
Incidence -
Laryngoscopy - methods
Middle Aged -
Neck - surgery
Retrospective Studies -
Risk Factors -
Vocal Cord Paralysis - diagnosis Vocal Cord Paralysis - epidemiology Vocal Cord Paralysis - etiology

Find related publications in this database (Keywords)
Recurrent nerve paralysis
Hoarseness
Voice disorder
Esophageal cancer
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