Diagnostics of superior laryngeal nerve paresis and therapy initiation for voice, swallowing and airway cleaning

The effects of paresis of the superior laryngeal nerve (NLS) range from voice and swallowing disorders to severe respiratory diseases, including chronic recurrent pneumonia. Their incidence after cervical surgery is undefined. The aim of current studies is to develop uniform diagnostics and classification according to severity despite variable clinical characteristics.

The study collective consists of patients after operations on the thyroid gland, soft tissues and vessels, cervical spine and skull base. The side-differentiated function of the NLS is investigated by means of 3D-based endoscopic evaluation of the vocal cord tension and supraglottic sensitivity. In particular, the graphical measurement of the glottis and vocal fold length as well as the latency time-detection of the "laryngeal adductor reflex" (LAR) after transnasal application of methylene blue-colored liquid are investigated.

First results of pilot studies show a relevant number of paresis of the NLS especially in early investigations after thyroid surgery with intact mobility of the vocal folds.

The standardization of diagnostics and classification of NLS paresis should lead to a higher sensitivity of the examiner and to a dynamization in the initiation of therapy. In this way, the long-term consequences of unrecognized NLS paresis, for example chronic aspiration pneumonia, are avoided.

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Publication History

Article published online:
10 June 2020