The aim of the study was to specify and collect important information on the anatomy of the laryngeal nerves and the types of paralysis, as well as paresis and fixation, which is not due to dysfunction of the recurrent laryngeal nerve, but is caused by immobility of the vocal fold as a result of a mechanical obstruction. We focused on the analysis of this condition in terms of clinical symptoms contributing to phoniatric disorders, including dysphonia in the majority of patients with palsy of the laryngeal nerves, as well as the occurrence of dysphagia in slightly more than 30% of people suffering from paralysis. Changes in the patient’s quality of life are significant enough to develop the subject in terms of presenting the possibilities of diagnosis, and to present the types of treatment of phoniatric dysfunctions, because an increasing number of patients decide to undergo surgical rehabilitation, including such surgical procedures as thyreoplasty,aimed at improving the quality of life of patients.

Review Methods:
The focus was on finding the most up-to-date information from the world of science, both on the Internet and in printed literature. Searching Internet resources was carried out with the use of medical publication databases Embase and UpToDate. In addition, part of the bibliography was found on PubMed and PubMed Central. The exploration process was based on key words. A review of the literature was carried out using the basic terms: retrograde laryngeal nerve, in combination with the following entries: paralysis, aphonia, diagnosis, treatment. All the publications selected, with one exception about acute bilateral recurrent palsy of the laryngeal nerve, published in 1988, were published in the 21st century. Special emphasis was placed on presenting the most up-to-date knowledge possible, therefore the vast majority of the literature was published after 2014. Several items published in the current calendar year can be found in the bibliography. Clinical trials were also taken into account, paying particular attention to the number of patients tested, the selection of the research group, research methods and analysis of the results. Many of the online sources found did not meet the selected criteria, most often because the subject was incomplete or the results were reported from too small a group of patients. The criteria adopted while browsing the printed literature were primarily the year of publication and the thematic scope of the issues described.

Jurkiewicz K, Markowska D..Phoniatric evaluation, diagnosis and treatment of voice disorders in the laryngeal nerves paralysis. J Pre-Clin Clin Res. 2022; 16(3): 114–117. doi: 10.26444/jpccr/152939
Gworys B. Kompendium z anatomii prawidłowej człowieka. Wrocław: Medpharm Polska; 2019. II: p. 114.
Wiechno W. Tyreoidektomia – jak chronić nerw wsteczny. Chirurgia po Dyplomie. 2018; 4.
Marchesi M, Biffoni M, Faloci C, Nobili Benedetti R, Notari P, Mariotti F, Cresti R. Il nervo laringeo inferiore non ricorrente: descrizione di 7 casi osservati dal 1987 [The inferior nonrecurrent laryngeal nerve: a report of 7 cases observed since 1987]. G Chir. 2000 Jan-Feb;21(1–2):25–8. Italian. PMID: 10732377.
Yetişir F, Özkardeş AB, Dündar HZ, Birkan B, Çiftci AB, Kılıç M. Nonrecurrent laryngeal nerve. Ulus Cerrahi Derg. 2013 May 28;30(2):112–4. doi: 10.5152/UCD.2013.22. PMID: 25931895; PMCID: PMC4379830.
Henry BM, Sanna S, Graves MJ, Vikse J, Sanna B, Tomaszewska IM, Tubbs RS, Walocha JA, Tomaszewski KA. The Non-Recurrent Laryngeal Nerve: a meta-analysis and clinical considerations. PeerJ. 2017 Mar 21;5:e3012. doi: 10.7717/peerj.3012. PMID: 28344898; PMCID: PMC5363258.
Weiand G, Mangold G. Verlaufsvarietäten des Nervus laryngeus inferior; Chirurgische Anatomie, Klassifikation, Diagnostik. Springer Medizin. 2004; 2.
Rosenthal LH, Benninger MS, Deeb RH. Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope. 2007; 117(10): 1864–70.
Gelbard A, Francis DO, Sandulache VC, Simmons JC, Donovan DT, Ongkasuwan J. Causes and consequences of adult laryngotracheal stenosis. Laryngoscope. 2015; 125: 1137–1143.
Laubert A. Acute bilateral recurrent laryngeal nerve paralysis, a symptom of Shy-Drager syndrome. HNO. 1988; 36(7): 290–2.
Olszewski J, Nowosielska-Grygiel J. Nowe metody diagnostyczne oceny czynności głosu dla potrzeb foniatry i logopedy. Logopaedica Lodziensia. 2017; 1: 91–99.
Misiołek M, Stelmańska K, Twardokęs M, Sowa P, Lisowska G. Operacyjne uszkodzenia nerwów krtaniowych. Pol Przeg Otorynolaryngol. 2014; 3: 15–19.
Berger G, Kosztyła-Hojna B, Chyczewski L. Wpływ anatomicznych uwarunkowań nerwów krtaniowych na wyniki neuromonitoringu śródoperacyjnego w zabiegach tyroidektomii oraz na wyniki funkcjonalne po laryngektomiach oszczędzających. Pol J Surg. 2019; 91(2): 30–37.
Laccourreye O, Papon JF, Kania R, Ménard M, Brasnu D, Hans S. Unilateral laryngeal paralyses: epidemiological data and therapeutic progress. Presse Med. 2003; 32(17): 781–6.
Orestes MI, Chhetri DK. Superior laryngeal nerve injury: effects, clinical findings, prognosis, and management options. Curr Opin Otolaryngol Head Neck Surg. 2014; 22(6): 439–43.
Corrado B, Ciardi G, Bargigli C. Rehabilitation Management of the Charcot-Marie-Tooth Syndrome: A Systematic Review of the Literature. Medicine. 2016; 95(17): e3278.
Misono S, Merati AL. Evidence-based practice: evaluation and management of unilateral vocal fold paralysis. Otolaryngol Clin North Am. 2012; 45(5): 1083–108.
Dankbaar JW, Pameijer FA. Vocal cord paralysis: anatomy, imaging and pathology. Insights Imaging. 2014; 5(6): 743–51.
Madden LL, Rosen CA. Evaluation of Vocal Fold Motion Abnormalities: Are We All Seeing the Same Thing? J Voice. 2017; 31(1): 72–77.
Sean Parker Institute for the Voice. Weill Cornell Medical College site https://voice.weill.cornell.ed... [access: 21.08.2022].
UCI Health Voice & Swallowing Center site [access: 21.08.2022).
Sean Parker Institute for the Voice https://voice.weill.cornell.ed... [access: 21.08.2022].
Estes C, Sadoughi B, Mauer E, Christos P, Sulica L. Laryngoscopic and stroboscopic signs in the diagnosis of vocal fold paresis. Laryngoscope. 2017; 127(9): 2100–2105.
Rybakovas A, Bausys A, Matulevicius A, et al. Recurrent laryngeal nerve injury assessment by intraoperative laryngeal ultrasonography: a prospective diagnostic test accuracy study. Videosurgery and Other Miniinvasive Techniques. 2019; 14(1): 38–45.
Papadakis CE, Asimakopoulou P, Proimos E, Perogamvrakis G, Papoutsaki E, Chimona T. Subjective and Objective Voice Assessments After Recurrent Laryngeal Nerve-Preserved Total Thyroidectomy. J Voice. 2017; 31(4): 515.e15–515.e21.
León Gómez NM, Delgado Hernández J, Luis Hernández J, Artazkoz del Toro JJ. Objective Analysis Of Voice Quality In Patients With Thyroid Pathology. Clin Otolaryngol. 2022; 47: 81–87.
Zraick RI, Kempster GB, Connor NP, et al. Establishing validity of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Am J Speech Lang Pathol. 2011; 20(1): 14–22.
Jiang Y, Gao B, Zhang X, Zhao J, Chen J, Zhang S, Luo D. Prevention and treatment of recurrent laryngeal nerve injury in thyroid surgery. Int J Clin Exp Med. 2014; 7(1): 101–7.
Kneisz L, Volk GF, Mayr W, Leonhard M, Pototschnig C, Schneider-Stickler B. Objectivation of laryngeal electromyography (LEMG) data: turn number vs. qualitative analysis. Eur Arch Otorhinolaryngol. 2020; 277(5): 1409–1415.
Culp JM, Patel G. Recurrent Laryngeal Nerve Injury. NLoM Online (access: 2022.05.23).
Laccourreye O, Malinvaud D, Ménard M, Bonfils P. Unilateral laryngeal nerve paralysis in the adult: Epidemiology, symptoms, physiopathology and treatment. Presse Med. 2014; 43(4 Pt 1): 348–52.
Woźnicka E, Niebudek-Bogusz E, Śliwińska-Kowalska M. Ocena efektów terapii głosu w dysfonii porażennej – studium przypadku. Otorynolaryngol. 2011; 10(3): 138–145.
Journals System - logo
Scroll to top