Crumley R L
Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange 92668.
J Voice. 1994 Mar;8(1):79-83. doi: 10.1016/s0892-1997(05)80323-6.
Recurrent laryngeal nerve (RLN) injury [without injury to the superior laryngeal nerve (SLN)] is the most common traumatic neurolaryngological lesion. The acute effects are immediate flaccidity of the ipsilateral vocal fold, loss of abduction and adduction, severe dysphonia to complete paralytic aphonia, and, frequently, aspiration of food and drink into the trachea. This article reviews the function of the four intrinsic laryngeal muscles innervated by the RLN and the individual effects of RLN transection on these muscles. Following acute denervation, the subsequent progression is either chronic denervation or nerve regeneration with laryngeal muscle reinnervation. Four possible scenarios are discussed here: complete reinnervation with synkinesis, partial reinnervation with synkinesis, mixed RLN injuries, and no reinnervation (complete paralysis). Electromyography may eventually assist the laryngologist in establishing these diagnoses, but currently not enough normative data exist for confirming laryngeal synkinesis unequivocally in every case. Treatment is generally by Teflon injection, medialization thyroplasty, arytenoid adduction procedures, or reinnervation by nerve transfer. The author's preference is nerve transfer, insofar as the quality of resultant phonatory voice, in his hands, has been superior to the other techniques.
喉返神经（RLN）损伤[不伴有喉上神经（SLN）损伤]是最常见的创伤性神经喉病变。急性影响包括同侧声带立即松弛、外展和内收功能丧失、严重发音障碍至完全麻痹性失音，并且经常出现食物和饮料误吸入气管的情况。本文回顾了由喉返神经支配的四块喉内肌的功能以及喉返神经横断对这些肌肉的个体影响。急性去神经支配后，随后的进展要么是慢性去神经支配，要么是神经再生伴喉肌再支配。这里讨论了四种可能的情况：完全再支配伴联动、部分再支配伴联动、混合性喉返神经损伤以及无再支配（完全麻痹）。肌电图最终可能有助于喉科医生做出这些诊断，但目前尚无足够的规范数据来明确在每种情况下确认喉联动。治疗通常采用特氟龙注射、甲状软骨成形术、杓状软骨内收手术或神经移植再支配。就作者而言，他更倾向于神经移植，因为在他手中，由此产生的发声质量优于其他技术。
