{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T21:30:48Z","timestamp":1783632648351,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Neoadjuvant targeted therapy has emerged as a promising treatment strategy for locally aggressive thyroid cancer. Its impact on tumor and adjacent tissues remains a nascent area of study. Here we report on a series of six subjects with locally advanced thyroid cancer and recurrent laryngeal nerve (RLN) paralysis who experienced recovery of RLN function with neoadjuvant treatment and describe the morphologic and electrophysiologic characteristics of these recovered nerves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a multicenter retrospective review. Descriptive analysis was conducted to examine the following parameters for recovered nerves: (1) nerve morphology, characterized as Type A (involving epineurium only) versus Type B (extending beyond epineurium); (2) proximal stimulability (normal vs. abnormal vs. absent); and (3) surgical management (resection vs. preservation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six subjects with unilateral VFP were identified. Median time to return of VF mobility was 3\u2009months (range 2\u201313.5). All nerves (100%) were noted to have Type A morphology at surgery. Proximal stimulability was normal in four subjects (66.7%), abnormal in one (16.7%), and absent in one (16.7%). Nerves that had improvement of function through neoadjuvant therapy were able to be surgically preserved in five subjects (83.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This represents the first characterization of RLNs that have recovered function with neoadjuvant treatment of locally advanced thyroid cancer. Although much remains unknown, our findings indicate carcinomatous neural invasion is a reversible process and recovered nerves may demonstrate normal morphology and electrophysiologic activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:3415\u20133419, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31304","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T10:49:20Z","timestamp":1706093360000},"page":"3415-3419","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Recovery of Recurrent Laryngeal Nerve Function With Neoadjuvant Treatment: Neural Characterization"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5436-3649","authenticated-orcid":false,"given":"Marika D.","family":"Russell","sequence":"first","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2013Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5611-5833","authenticated-orcid":false,"given":"Amr H.","family":"Abdelhamid Ahmed","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2013Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zipei","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."},{"name":"Department of Head and Neck Surgery The University of Texas M. D. Anderson Cancer Center  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"David C.","family":"Shonka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia Health System  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1358-774X","authenticated-orcid":false,"given":"Amanda S.","family":"Karcioglu","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2013Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts U.S.A."},{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery NorthShore University HealthSystem  Evanston Illinois U.S.A."},{"name":"The University of Chicago, Pritzker School of Medicine  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka J.","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Kaiser Permanente Santa Clara Medical Center  Santa Clara California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Kyriazidis","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2013Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer H.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"McGovern Medical School at University of Texas Health Science Center  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejas S.","family":"Athni","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong C.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori J.","family":"Wirth","sequence":"additional","affiliation":[{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Zafereo","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas M. 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Anderson Cancer Center  Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5373-9181","authenticated-orcid":false,"given":"Gregory W.","family":"Randolph","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2013Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts U.S.A."},{"name":"Department of Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2022.0504"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2022.0506"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880160211"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10058"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199707000-00012"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0136"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30115"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27360"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813504735"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199107000-00003"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2007.0124"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.08.009"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000191472.02720.1f"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2011.01.005"},{"key":"e_1_2_6_16_1","unstructured":"A Phase 2 Study of Neoadjuvant Lenvatinib in Locally Advanced Invasive Thyroid Cancer [Internet]. Report No.: NCT04321954.2022. Accessed April 2 2023.https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04321954."}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T09:58:28Z","timestamp":1718618308000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,24]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1002\/lary.31304"],"URL":"https:\/\/doi.org\/10.1002\/lary.31304","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,24]]},"assertion":[{"value":"2023-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}