Exploration and reinnervation of recurrent laryngeal nerve injury in thyroid surgery        LI Meng, ZHENG Hong-liang. Department of Otolaryngology Head & Neck Surgery, the Second Military Medical University, Shanghai 200433, China
Corresponding author：ZHENG Hong-liang，E-mail：zheng_hl2004@163.com
Abstract    As one of the most common and serious complications of thyroid surgery, unilateral vocal cord paralysis caused by recurrent laryngeal nerve (RLN) injury can lead to varying degrees of hoarseness, aspiration, and coughing, which affects quality of life of patients. Traditional treatment methods including vocal fold injection, thyroplasty can improve vocal function. However, the voice is lack of regulatory function of tone and volume, and long-term efficacy is not satisfactory. The best treatment for vocal cord paralysis is reinnervation of the RLN so as to recover the physiological function of the paralyzed larynx, which consists of nerve exploration and decompression, end to end anastomosis of RLN, ansa cervicalis to RLN anastomosis, free nerve graft transfer, nerve muscular pedicle, nerve implantation and reinnervation surgery combined with medialization of vocal cord. For thyoid surgery-related UVFP patients, early nerve decompression has the best effect, and ansa cervicalis to RLN anastomosis can also be effective in restoring the pronunciation function of the larynx. And for those who had long denervation course, reinnervation surgery combined with mediliazation should be performed. Selection of the laryngeal reinnervation protocols should depend on the course, severity and type of nerve injury.