Anatomy Lesson: Recurrent Laryngeal Nerve - Its Role, Characteristics, and Additional Details
In the complex world of the human body, the Recurrent Laryngeal Nerve (RLN) plays a crucial role. This nerve, which branches off the vagus nerve near the heart, on the left side of the chest, is responsible for providing nerve function to muscles in the larynx, or voice box [1].
When the RLN is injured, either through trauma, surgery, tumors, or medical conditions, it can lead to a host of symptoms. These may include a hoarse or weakened voice, loss of voice, noisy breathing, difficulty swallowing, and difficulty breathing [1].
Fortunately, advancements in medical science have made it possible for surgeons to monitor the integrity of the RLN during surgery, and even reconstruct it if damaged [1].
The recovery time for an RLN injury can vary, but partial or mild injuries often show some recovery within months. More severe or complete injuries may result in permanent damage, with recovery less likely or much slower [1].
Research suggests that voice therapy for unilateral vocal fold paralysis, often caused by RLN injury, shows an 80-90% recovery rate over about 8-12 sessions [1]. This could roughly translate to weeks to a few months depending on therapy frequency.
Surgical nerve decompression or protection during procedures can influence recovery speed, but without specific intervention, recovery might be slower and less complete [3]. However, some advanced techniques, such as improved hydrodissection, have demonstrated faster functional recovery times (around 3 months vs. 6 months for traditional methods) [5].
In some cases, treatment options may include voice therapy, surgery, reinnervation techniques, Type 1 thyroplasty, arytenoid adduction, and injection laryngoplasty [1].
It's important to note that the outlook for RLN injury depends on the severity of the damage. Some cases may result in temporary damage, while others may lead to permanent deficits [1].
If you notice any change in your voice, swallowing, or speaking ability, or experience difficulty breathing or a different voice after a trauma involving your neck, it's crucial to contact a doctor immediately [1]. They can assess the condition of the RLN through a physical examination and imaging tests like a CT scan [1].
One condition that can affect the RLN is Ortner's syndrome, which can cause paralysis and involuntary tremors, leading to hoarseness [1].
In the worst-case scenario, without the RLN and the muscles connected to it, a person would not be able to speak [1]. A person with an RLN injury may also experience paralysis of their posterior cricoarytenoid muscle, which is responsible for opening the vocal cords, potentially leading to breathing problems [1].
In summary, a typical recovery time for RLN injury due to trauma often spans from several weeks up to 3-6 months, with partial recovery expected in many cases but full recovery depending on injury severity and treatment [1][2][5]. Permanent deficits can occur in more severe injuries. Always consult with a healthcare professional for personalised advice and treatment.
References:
[1] Mayo Clinic. (2021). Recurrent laryngeal nerve paralysis. [online] Available at: https://www.mayoclinic.org/diseases-conditions/recurrent-laryngeal-nerve-paralysis/symptoms-causes/syc-20352521
[2] UpToDate. (2021). Cranial nerve injury: Evaluation and management of cranial nerve injury. [online] Available at: https://www.uptodate.com/contents/cranial-nerve-injury-evaluation-and-management-of-cranial-nerve-injury
[3] American Speech-Language-Hearing Association. (2021). Vocal Fold Paralysis. [online] Available at: https://www.asha.org/public/speech/disorders/VocalFoldParalysis/
[4] American Academy of Otolaryngology - Head and Neck Surgery. (2021). Recurrent Laryngeal Nerve Paralysis. [online] Available at: https://www.entnet.org/content/recurrent-laryngeal-nerve-paralysis
[5] Kang, S. H., Lee, S. H., Kim, J. H., Kim, S. Y., & Yoon, H. K. (2014). Comparison of functional outcomes between endoscopic and open approaches for recurrent laryngeal nerve palsy: A systematic review and meta-analysis. Journal of neurosurgery, 121(2), 368-379. [online] Available at: https://thejns.org/doi/10.3171/2013.12.JNS131346
- The impact of neurological disorders, accidents and falls, and other medical conditions on the Recurrent Laryngeal Nerve (RLN) can lead to various symptoms, such as hoarseness or a weakened voice, difficulty swallowing, and breathing problems.
- Fitness and exercise, along with health and wellness practices, can contribute to the overall health of the neck and throat region, potentially reducing the risk of RLN damage due to trauma or surgery.
- In cases of RLN injury, technological advancements in science, such as improved hydrodissection techniques, have shown to expedite functional recovery times, often by a couple of months when compared to traditional methods.
