Recurrent Laryngeal Nerve (RLN) Reinnervation

Recurrent laryngeal nerve (RLN) reinnervation is a surgical option that helps manage 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 some children with vocal cord paralysis, the muscle of the vocal cord is not receiving a signal from the RLN. To confirm that this is the cause of the vocal cord paralysis, your child will undergo a laryngeal electromyography (EMG). An EMG is a diagnostic test that shows whether the paralysis is caused by nerve paralysis, structural problems, scarring or something else. If the EMG confirms that nerve paralysis is at the root of the problem, then the reinnervation is performed.

During this 2- to 3-hour procedure, a small incision is made in the neck and the damaged RLN is attached to another nerve called the Ansa Cervicalis nerve. An injection of a plumping material is given to the vocal fold that is paralyzed to give a temporary improvement in the voice while the reinnervation begins to take effect.

Recurrent laryngeal nerve reinnervation allows the nerve that is functioning to send signals to the damaged nerve. Over time the vocal cord will receive improved signals and reduce the breathiness in the voice. This is typically an outpatient procedure.

Some children will only have the injection of the plumping material. This is used as a test to see whether surgery would help to improve the child's voice. Injection of the plumping material is a short-term fix. Results of the injection alone can be inconsistent.