{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T19:37:24Z","timestamp":1773085044695,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"S11","license":[{"start":{"date-parts":[[2015,8,8]],"date-time":"2015-08-08T00:00:00Z","timestamp":1438992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To establish the benefit of ansa cervicalis\u2010recurrent laryngeal nerve reinnervation (ANSA\u2010RLN) for the management of dysphonia secondary to unilateral vocal cord paralysis (UVCP) in children. Children treated with ANSA\u2010RLN for the management of dysphonia secondary to unilateral vocal fold immobility will have superior acoustic, perceptual, and stroboscopic outcomes compared to injection laryngoplasty and observation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case\u2010series chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Laryngeal, perceptual, and acoustic analysis of dysphonia was performed in 33 children (age 2\u201316 years) diagnosed with UVCP. Comparison of pre\u2010post function for treatment groups (no treatment, injection laryngoplasty, ANSA\u2010RLN) with additional comparison between gestational ages, age at initial evaluation, and gender were examined. Perceptual measures included Pediatric Voice Handicap Index (pVHI) and Grade, Roughness, Breathiness, Asthenia, Strain (GBRAS) perceptual rating. Objective measures included semitone (ST) range, jitter%, shimmer%, noise\u2010to\u2010harmonic ratio, voicing, and maximum phonation time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Post\u2010treatment, pVHI, jitter%, and ST were significantly improved for ANSA\u2010RLN subjects compared to injection subjects. Improved function (laryngeal diadochokinesis, pVHI, GRBAS, and\/or acoustic) was observed in all ANSA\u2010RLN subjects who had vocal fold paralysis as the only laryngeal diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study presents one of the largest studies of pediatric vocal fold paralysis diagnosis and treatment. The study looks at the spectrum of function in patients with UVCP and looks at the outcomes of options: no treatment, injection laryngoplasty, and ANSA\u2010RLN. Although surgical outcomes vary, both injection laryngoplasty and ANSA\u2010RLN show benefit in laryngeal function, voice stability, voice capacity, perceptual rating, and pVHI scores. Both injection laryngoplasty and ANSA\u2010RLN showed improvements post\u2010treatment, and should be considered for management of pediatric UVCP. However, the ANSA\u2010RLN group showed better and longer\u2010lasting perceptual and acoustic parameters in comparison with the injection and control groups. Reinnervation, even long term after the onset of vocal fold paralysis, should be considered a viable permanent treatment for pediatric UVCP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 125:S1\u2013S15, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25538","type":"journal-article","created":{"date-parts":[[2015,8,8]],"date-time":"2015-08-08T13:36:08Z","timestamp":1439040968000},"source":"Crossref","is-referenced-by-count":55,"title":["Recurrent laryngeal nerve reinnervation in children: Acoustic and endoscopic characteristics pre\u2010intervention and post\u2010intervention. A comparison of treatment options"],"prefix":"10.1002","volume":"125","author":[{"given":"Karen B.","family":"Zur","sequence":"first","affiliation":[{"name":"Department of Pediatric Otolaryngology The Children's Hospital of Philadelphia Philadelphia Pennsylvania U.S.A"},{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Perelman School of Medicine of The University of Pennsylvania Philadelphia Pennsylvania U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda M.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology The Children's Hospital of Philadelphia Philadelphia Pennsylvania U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20148"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.126.1.21"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-1129"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.07.028"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.8.767"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2008.05.004"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.803"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2006.09.005"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/21.2.175"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2013\/11-0242)"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2010\/09-0105)"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(05)80313-3"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2012.03.005"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2006.09.004"},{"key":"e_1_2_7_16_1","unstructured":"CarrollLM CaroffA ZurKB. Pediatric Voice Handicap Index values in dysphonic children. Paper presented at: The Voice Foundation 42nd Annual Symposium: Care of the Professional Voice; June 2 2013; Philadelphia PA."},{"key":"e_1_2_7_17_1","unstructured":"KhoslaSM. Use of Radiesse for repair of vocal cord. 12\/10\/2009. Available at:http:\/\/www.netwellness.org\/question.cfm\/76359.htm. Accessed May 6 2015."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0817"},{"key":"e_1_2_7_19_1","first-page":"134","article-title":"Treatment of recurrent laryngeal nerve paralysis by anastomosis","volume":"43","author":"Frazier CH","year":"1926","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198606000-00004"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21754"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20773"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.25538","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.25538","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T02:59:33Z","timestamp":1696042773000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.25538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,8]]},"references-count":21,"journal-issue":{"issue":"S11","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1002\/lary.25538"],"URL":"https:\/\/doi.org\/10.1002\/lary.25538","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,8]]}}}