ASO Author Reflections: Prognostic Factors for Recovery from Left Recurrent Laryngeal Nerve Palsy After Minimally Invasive McKeown Esophagectomy: A Retrospective Study

Excerpt

A crucial step in the treatment of esophageal squamous cell carcinoma is the dissection of upper mediastinal lymph nodes, typically performed using minimally invasive esophagectomy. However, a significant concern associated with this approach is the potential for recurrent laryngeal nerve (RLN) palsy, particularly on the left side.¹ Due to its crucial role as one of the main motor nerves of the larynx and its branches that extend to the cricopharyngeus muscles, forming the upper esophageal sphincter, the RLN is involved in various vital processes such as breathing, speaking, coughing, and swallowing. Deficiencies in these functions are closely associated with RLN injury, which can lead to serious pulmonary complications and increased rates of morbidity and mortality.² Because of the potential self-limiting nature of RLN palsy, a “watchful waiting” period of at least 6 months is often recommended before definitive management. Ideally, early identification of patients with a low probability of spontaneous RLN palsy recovery and subsequent timely interventions could potentially mitigate the risk of aspiration. However, available data on this topic are limited. …