Abstract：
OBJECTIVE: Injury to the external branch of the superior laryngeal nerve (EBSLN) causes low-pitch voice and voice fatigue, particularly in female subjects, and available treatments are limited. Here, we assess a novel surgical procedure to restore a high-tone voice: ansa cervicalis to EBSLN anastomosis (A-E anastomosis).
METHODS: Between November 2012 and April 2022, 13 patients (12 female) underwent unilateral EBSLN resection and A-E anastomosis, while 20 (16 female) underwent EBSLN resection during thyroid surgery. Patients (4494 women and 1025 men) with normal laryngoscopy scheduled for thyroid surgery served as normal controls. Phonatory function was examined using a Phonation Analyzer PA-1000 preoperatively and intermittently postoperatively.
RESULTS: In patients who underwent A-E anastomosis, high-tone voice pitch decreased significantly postoperatively (673.9-471.5 Hz, p = 0.047), with restoration achieved within 5 months. The mean voice pitch in female patients who underwent A-E anastomosis, EBSLN resection, and controls were 580.4, 522.8, and 682.0 Hz, respectively, indicating a significant decrease in EBSLN resection patients than controls (p = 0.002). The (mean - 1SD) of high-tone voice pitch in female controls was 497 Hz; exceeding this may indicate recovery to a high-tone voice. Overall, 73% (8/11) of A-E anastomosis patients exceeded this value, which was marginally larger than the 43% (6/14) who underwent EBSLN resection. Data on male subjects are limited. There were no cases of adverse functional or cosmetic events.
CONCLUSIONS: A-E anastomosis, a novel simple procedure, restored high-tone voice to some extent without any adverse events and thus warrants further investigation.
METHODS: 3 Laryngoscope, 134:3868-3873, 2024.
METHODS: Between November 2012 and April 2022, 13 patients (12 female) underwent unilateral EBSLN resection and A-E anastomosis, while 20 (16 female) underwent EBSLN resection during thyroid surgery. Patients (4494 women and 1025 men) with normal laryngoscopy scheduled for thyroid surgery served as normal controls. Phonatory function was examined using a Phonation Analyzer PA-1000 preoperatively and intermittently postoperatively.
RESULTS: In patients who underwent A-E anastomosis, high-tone voice pitch decreased significantly postoperatively (673.9-471.5 Hz, p = 0.047), with restoration achieved within 5 months. The mean voice pitch in female patients who underwent A-E anastomosis, EBSLN resection, and controls were 580.4, 522.8, and 682.0 Hz, respectively, indicating a significant decrease in EBSLN resection patients than controls (p = 0.002). The (mean - 1SD) of high-tone voice pitch in female controls was 497 Hz; exceeding this may indicate recovery to a high-tone voice. Overall, 73% (8/11) of A-E anastomosis patients exceeded this value, which was marginally larger than the 43% (6/14) who underwent EBSLN resection. Data on male subjects are limited. There were no cases of adverse functional or cosmetic events.
CONCLUSIONS: A-E anastomosis, a novel simple procedure, restored high-tone voice to some extent without any adverse events and thus warrants further investigation.
METHODS: 3 Laryngoscope, 134:3868-3873, 2024.
摘要：
目的：喉上神经（EBSLN）外支的损伤会引起低音和语音疲劳，特别是在女性科目中，可用的治疗方法有限。这里,我们评估了一种新的外科手术，以恢复高音的声音：颈柄与EBSLN吻合术（A-E吻合术）。
方法：在2012年11月至2022年4月之间，13例患者（12例女性）接受了单侧EBSLN切除和A-E吻合术，而20名（16名女性）在甲状腺手术期间接受了EBSLN切除术。计划进行甲状腺手术的正常喉镜检查的患者（4494名女性和1025名男性）作为正常对照。术前和术后间歇性使用语音分析仪PA-1000检查语音功能。
结果：在接受A-E吻合术的患者中，高音音高在术后显着降低（673.9-471.5Hz，p=0.047),在5个月内恢复。接受A-E吻合术的女性患者的平均语音音调，EBSLN切除,对照组为580.4、522.8和682.0Hz，分别,表明EBSLN切除患者比对照组显着减少（p=0.002）。女性对照组的高音音高（平均-1SD）为497Hz；超过这个数字可能表明恢复到高音语音。总的来说,73%(8/11)的A-E吻合患者超过该值,略高于接受EBSLN切除术的43%(6/14)。关于男性受试者的数据有限。没有不良功能或美容事件的病例。
结论：A-E吻合术，一个新颖的简单程序，在一定程度上恢复了高音语音，没有任何不良事件，因此值得进一步调查。
方法：3喉镜，2024.
方法：在2012年11月至2022年4月之间，13例患者（12例女性）接受了单侧EBSLN切除和A-E吻合术，而20名（16名女性）在甲状腺手术期间接受了EBSLN切除术。计划进行甲状腺手术的正常喉镜检查的患者（4494名女性和1025名男性）作为正常对照。术前和术后间歇性使用语音分析仪PA-1000检查语音功能。
结果：在接受A-E吻合术的患者中，高音音高在术后显着降低（673.9-471.5Hz，p=0.047),在5个月内恢复。接受A-E吻合术的女性患者的平均语音音调，EBSLN切除,对照组为580.4、522.8和682.0Hz，分别,表明EBSLN切除患者比对照组显着减少（p=0.002）。女性对照组的高音音高（平均-1SD）为497Hz；超过这个数字可能表明恢复到高音语音。总的来说,73%(8/11)的A-E吻合患者超过该值,略高于接受EBSLN切除术的43%(6/14)。关于男性受试者的数据有限。没有不良功能或美容事件的病例。
结论：A-E吻合术，一个新颖的简单程序，在一定程度上恢复了高音语音，没有任何不良事件，因此值得进一步调查。
方法：3喉镜，2024.
