neuromuscular pedicle surgery

After successful treatment of bilateral vocal cord abduction paralysis with neuromuscular grafts, Tucker (1977) used this technique to treat unilateral vocal cords with epithelial palsy and postoperative vocal cord recovery to adduction. Some scholars used this technique to treat unilateral vocal cord adduction disorders. Although the postoperative vocal cord adduction movement was not obvious, the patient's voice did improve. Some people think that the improvement of the sound is not the result of the nerve re-domination of the muscle musculature of the laryngeal muscle, but the injury, gravity, and changes in the position of the vocal cords. Treatment of diseases: congenital vocal dysplasia Indication Neuromuscular surgery is suitable for: 1. Unilateral vocal cord paralysis, vocal cords can not be adducted and make pronunciation difficult. 2. The unilateral vocal cords cannot be received by the vocal dysfunction and require improvement of the vocal function. Contraindications 1. The sacral cartilage is fixed. 2. The original injury of the hypoglossal nerve sac. Preoperative preparation Direct laryngoscopy is performed to test the activity of the sacral cartilage. This procedure is only possible if the sacral cartilage is normal. Surgical procedure 1. Position and incision in a supine position, the head is biased to the opposite side, the skin of the neck is routinely disinfected, and the head is covered with a sterile towel. 2. Prepare the anterior border of the sternocleidomastoid muscle of the neuromuscular pedicle and pull it backward, and find the branch of the hypoglossal nerve sac to the anterior abdomen of the scapular humerus. Along the nerve branch, the nerve is actually separated into the muscle, and the muscle block of 2 to 3 mm 3 is cut out, and the nerve is placed in the surrounding tissue space for use. 3. Exposure of the nailfold muscle to the lateral anterior cervical band muscle, exposing the thyroid cartilage flap. Incision is made in the lower half to cut the perichondrium. A square thyroid cartilage was removed to expose the lateral muscle fibers of the hypotenon muscle. 4. Transplant the neuromuscular pedicle on the nail muscle. Place the prepared neuromuscular pedicle on the surface of the nail muscle. Fix the muscle pedicle and the nail muscle with 2-0 needles with a 5-0 nylon thread. Note that the nerves in the pedicle should be tension free. 5. Close the perichondrium flap. Throat reduction. Suture by layer and close the incision. The slit has a built-in drain strip.