Reinnervation of paralyzed intralaryngeal muscles by axonal sprouting from adjacent intact muscles (the phenomenon of muscular neurotization) has been observed, but the source is uncertain. The potential for laryngeal reinnervation of the posterior cricoarytenoid muscle (PCA) from contralateral PCA motor nerve sprouting in a rabbit model was investigated. Unilateral PCA denervation was produced by vagotomy. The rabbits were examined for signs of PCA recovery for up to 6 months using fiberoptic endoscopy, electromyography (EMG), and histology. No return of vocal cord abduction, EMG activity, or any nerve sprouting across the midline from the intact PCA was found. We conclude that there is no significant spontaneous intralaryngeal muscular neurotization to the paralyzed PCA. The clinical ramifications of our data will be discussed.
Bickerstaff brainstem encephalitis (BBE) is a rare inflammatory demyelinating disease with rapid progression typically followed by complete recovery. Reports of dysphagia in this population are limited and general. The purpose of this article is to heighten awareness of the potential for silent aspiration in patients with BBE. This article details the nature of dysphagia during the recovery phase of BBE and includes findings from serial videofluoroscopic swallowing evaluations. In addition, it shows the impact of cognitive impairment on the ability to eat safely. Early instrumental swallowing evaluation, close monitoring, and conservative management are essential to ensure safety in patients recovering from BBE.
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