Laryngeal Nerve Repair(Restoring Voice & Airway Protection)
Advanced nerve reinnervation techniques designed to breathe life back into paralyzed vocal cords, restoring a strong voice and preventing aspiration.
Understanding Laryngeal Nerve Injury
The recurrent laryngeal nerve (RLN) is a critical branch of the vagus nerve that controls all but one of the muscles of the voice box (larynx). Because of its long, looping course through the neck and upper chest, it is highly susceptible to injury during thyroid surgery, anterior spine surgery, or from tumors.
When the RLN is damaged, the vocal cord on that side becomes paralyzed and sits in an open or partially open position. This results in a weak, breathy, or hoarse voice (dysphonia). More critically, the vocal cords cannot close tightly to protect the airway during swallowing, leading to choking and a high risk of pneumonia (aspiration).
While vocal cord injections or implants can push the paralyzed cord toward the middle (static procedures), Laryngeal Reinnervation (Nerve Repair) goes a step further. By surgically splicing a healthy nerve into the damaged RLN, Dr. Jowett restores live muscle tone to the vocal cord, preventing it from bowing out over time and yielding a more natural, dynamic voice.
Common Causes of Paralysis
Laryngeal nerve repair is indicated when vocal cord paralysis is permanent and structural nerve damage is known or strongly suspected.
The Transformative Impact
- Restored Vocal Power: Re-establishing muscle tone allows the vocal cords to press firmly together, bringing back a loud, clear voice.
- Safe Swallowing: Prevents food and liquids from slipping between paralyzed cords and into the lungs, eliminating choking.
- Reduced Vocal Fatigue: Patients no longer have to push massive amounts of air to force a whisper, resolving end-of-day exhaustion.
- Long-Term Stability: Unlike fillers that resorb over time, nerve reinnervation permanently halts muscle atrophy for lasting results.
Surgical Precision & Technique
The most common and effective technique for laryngeal reinnervation is the Ansa Cervicalis to Recurrent Laryngeal Nerve Transfer.
During this procedure, Dr. Jowett locates the ansa cervicalis—a nearby nerve in the neck that provides tone to strap muscles but is not functionally missed when used as a donor. He then identifies the stump of the damaged RLN right where it enters the voice box. Using high magnification, he connects the healthy ansa cervicalis to the RLN. Over several months, the new nerve fibers grow into the vocal cord muscles, restoring their tension, bulk, and resting position.
Why Choose Revitalis?
Dr. Nate Jowett applies his profound expertise in complex head, neck, and facial nerve reconstruction directly to the delicate nerves of the larynx.
While many centers rely solely on vocal cord injections (which only act as temporary shims), Dr. Jowett frequently offers reinnervation to address the underlying neurological deficit. By restoring true, biological muscle tone to the vocal folds, he provides patients with a permanent, dynamic solution to voice and swallowing difficulties. His research into minimizing tissue trauma during laryngeal surgery further underscores his commitment to optimal vocal outcomes.
Selected References
- Use of a Microsecond Er:YAG Laser in Laryngeal Surgery Reduces Collateral Thermal Injury in Comparison to Superpulsed CO₂ Laser. Böttcher A, Jowett N, et al. Eur Arch Otorhinolaryngol. 2014 May; 271(5):1121-8.
- Reduction of Thermocoagulative Injury via Use of a Picosecond Infrared Laser (PIRL) in Laryngeal Tissues. Böttcher A, et al. Eur Arch Otorhinolaryngol. 2015 Apr; 272(4):941-948.