Pediatric Airway Disorders

Recurrent Laryngeal Nerve (RLN) Reinnervation

This is a surgical option for management of hoarseness due to a one-sided vocal cord paralysis or immobility. The left and right recurrent laryngeal nerves are responsible for vocal cord movement on their respective sides. In this two- to three-hour procedure, a small incision is made in the neck and the damaged RLN is attached to another nerve in the neck (the Ansa Cervicalis nerve).

The child typically remains in the hospital overnight for observation. This procedure allows the nerve that is functioning to send signals to the damaged nerve. Over time, the injured recurrent laryngeal nerve will begin to heal to regain its ability to send signals to the vocal cord. It does not lead to movement of the vocal cord, but it improves the tone and helps the vocal cords move closer together, improving the volume of the voice.

Since it takes several months for the nerve to receive the signal from the Ansa Cervicalis, a temporary injection is typically done to plump the injured vocal cord (see Vocal Fold Injection), giving the child a temporary improvement in the voice quality. 


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