Laryngeal Reinnervation as a Treatment Option for Permanent Unilateral Vocal Fold Paralysis

For unilateral vocal fold paralysis (UVFP) persisting beyond 6–12 months, laryngeal reinnervation provides neural input to maintain vocal fold bulk and tone while allowing gradual voice improvement over time. We report a 71-year-old male with recurrent hoarseness and aspiration despite prior vocal fold injection for idiopathic left UVFP. Ansa cervicalis-to-recurrent laryngeal nerve anastomosis resulted in progressive improvement of subjective and objective voice parameters over 12 months without complications. Laryngeal reinnervation centralized the paralyzed vocal fold, prevented atrophy, avoided inflammatory reactions from injected materials, and permitted future medialization procedures. This case demonstrates laryngeal reinnervation’s efficacy in carefully selected UVFP patients, achieving successful voice outcomes in an elderly individual.