Selective laryngeal reinnervation with separate phrenic and ansa cervicalis nerve transfers
| Autor: | R. J. Stolk, J. T. Van Lith-Bijl, Jeroen A.D.M. Tonnaer, Hans F. Mahieu, C. Groenhout, Pierre N.M. Konings |
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| Rok vydání: | 1997 |
| Předmět: |
Larynx
Video Recording Electromyography medicine Recurrent laryngeal nerve Animals Nerve Transfer Phrenic nerve Cervical Plexus Respiratory Distress Syndrome medicine.diagnostic_test Laryngoscopy business.industry Respiration Laryngeal Nerves General Medicine Anatomy medicine.disease Phrenic Nerve Vocal muscle Disease Models Animal medicine.anatomical_structure Otorhinolaryngology Posterior cricoarytenoid muscle Synkinesis Anesthesia Cats Surgery Female business Reinnervation |
| Zdroj: | Archives of otolaryngology--headneck surgery. 123(4) |
| ISSN: | 0886-4470 |
| Popis: | Objective: To perform selective reinnervation of the laryngeal abductor and adductor muscle groups after injury to the recurrent laryngeal nerve, recovering laryngeal function without impairment by synkinesis. Design: Ten cats underwent the surgical procedure. To reinnervate the posterior cricoarytenoid muscle (abductor), a phrenic nerve graft was anastomosed to the main trunk of the recurrent laryngeal nerve. The adductor branch was severed, and the proximal stump was buried in the posterior cricoarytenoid muscle. The sternohyoid branch of the ansa cervicalis was anastomosed to the distal stump to reinnervate the adductor muscle group. After a period of 10 weeks, the laryngeal function was evaluated with videolaryngoscopy and electromyography of the posterior cricoarytenoid and vocalis muscles. Results: Of the 10 cats, 9 could be evaluated. Laryngeal abductor function was comparable with the unaffected side in the 9 cats. During respiratory distress conditions, a minor compromise of the maximal abduction was observed in 5 cats. Phonation was not tested, but spontaneous adduction during expiration was seen in all cats. Reflex closure on ipsilateral, supraglottic, tactile mucosal stimulation was seen in only 2 cats. In each cat, evidence of nerve regeneration and reinnervation of both muscle groups was established with electromyography, electrical stimulation, and histological examination. Conclusions: Using this selective reinnervation procedure, good laryngeal function can be achieved in the cat model, which may be applicable in humans. By reinnervation of the vocalis muscle, muscle tonus is achieved, which is expected to improve voice quality. Using this procedure, however, no active reflex closure may be expected. Arch Otolaryngol Head Neck Surg. 1997;123:406-411 |
| Databáze: | OpenAIRE |
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