Surgical anatomy of the ansa cervicalis nerve: which branch to use for laryngeal reinnervation in humans?

Prades, J.‐M.; Gavid, M.; Dubois, Marie-Dominique; Dumollard, Jean Marc; Timoshenko, A.; Péoc’h, Michel

doi:10.1007/s00276-014-1355-x

Cited by 15 publications

(15 citation statements)

References 28 publications

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“…Although each method has its own advantages, we focused on hypoglossal nerve transfer to achieve powerful facial tone and movement. We also attempted to transfer the ansa cervicalis because its sacrifice results in less donor morbidity [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…The ansa cervicalis has been used for recurrent laryngeal nerve reconstruction after the resection of thyroid malignancies with nerve invasion. It has the advantage of avoiding donor morbidity because it has multiple anastomoses within the cervical plexus [ 13 , 14 ]. Considering the topographical and morphological variations in the ansa cervicalis, we selected the superior root of the ansa cervicalis, which is anatomically stable and easier to approach.…”

Section: Discussionmentioning

confidence: 99%

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Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes

Koo

Park

Ahn

et al. 2021

Arch Craniofac Surg

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Background: Transferring the hypoglossal nerve to the facial nerve using an end-to-end method is very effective for improving facial motor function. However, this technique may result in hemitongue atrophy. The ansa cervicalis, which arises from the cervical plexus, is also used for facial reanimation. We retrospectively reviewed cases where facial reanimation was performed using the ansa cervicalis to overcome the shortcomings of existing techniques of hypoglossal nerve transfer.Methods: The records of 15 patients who underwent hypoglossal nerve transfer were retrospectively reviewed. Three methods were used: facial reanimation with hypoglossal nerve transfer (group 1), facial nerve reanimation using the ansa cervicalis (group 2), and sural nerve interposition grafting between the hypoglossal nerve and facial nerve (group 3). In group 1, the ansa cervicalis was coapted to neurotize the distal stump of the hypoglossal nerve in a subset of patients. Clinical outcomes were evaluated using the House-Brackmann (H-B) grading system and Emotrics software.Results: All patients in group 1 (n = 4) achieved H-B grade IV facial function and showed improvements in the oral commissure angle at rest (preoperative vs. postoperative difference, 6.48° ± 0.77°) and while smiling (13.88° ± 2.00°). In groups 2 and 3, the oral commissure angle slightly improved at rest (group 2: 0.95° ± 0.53°, group 3: 1.35° ± 1.02°) and while smiling (group 2: 2.06° ± 0.67°, group 3: 1.23° ± 0.56°). In group 1, reduced tongue morbidity was found in patients who underwent ansa cervicalis transfer.Conclusion: Facial reanimation with hypoglossal nerve transfer, in combination with hypoglossal nerve neurotization using the ansa cervicalis for complete facial palsy patients, might enable favorable facial reanimation outcomes and reduce tongue morbidity. Facial reanimation using the ansa cervicalis or sural nerve for incomplete facial palsy patients did not lead to remarkable improvements, but it warrants further investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes

Koo

Park

Ahn

et al. 2021

Arch Craniofac Surg

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“…Os músculos infra-hióideos ocupam a parte anteromedial do pescoço e têm por função básica contribuir para a movimentação do osso hioide e da cartilagem tireóidea durante a vocalização, deglutição e mastigação (GRAY, 2005). No caso de paralisia unilateral de prega vocal, ramos da alça cervical podem ser utilizados para reinervação laríngea (FAOURY et al, 2019;PRADES et al, 2015). Dessa forma, caso lesada a alça cervical, funções importantes poderiam ser comprometidas, afetando a qualidade de vida dos indivíduos acometidos.…”

Section: Discussionunclassified

Dissecção Do Plexo Cervical Na Formação Médica: Aplicabilidades Clínicas E Cirúrgicas

Felipe¹,

Fornaziero²,

Gouvêa-e-Silva³

et al. 2021

Arq. Ciênc. Saúde Unipar

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A Anatomia da região cervical é de particular importância para os cirurgiões e clínicos de diversas especialidades médicas. Em se tratando da organização nervosa presente na região anterolateral do pescoço, encontra-se o plexo cervical, formado pelos ramos anteriores dos nervos cervicais C1 a C4, cuja função é promover a sensibilidade da pele anterolateral cervical, torácica anterossuperior e do couro cabeludo posterior, na cabeça, além de controlar a musculatura infra-hióidea e diafragmática. Logo, lesões a essa estrutura nervosa e aos seus ramos podem causar graves complicações ao corpo humano. Esse trabalho objetivou utilizar a dissecção da região anterolateral do pescoço como uma ferramenta pedagógica para o estudo das relações anatômicas dos nervos do plexo cervical observados durante essa prática, assim como relatar algumas de suas importâncias clínicas e cirúrgicas. O presente estudo é caracterizado como qualitativo/descritivo. A dissecação foi realizada semanalmente, durante o segundo semestre de 2018 e o primeiro semestre de 2019, com a supervisão do professor responsável e auxílio do técnico de laboratório, no Laboratório de aulas práticas da Universidade Estadual de Londrina (UEL). Considera-se que a dissecção da região anterolateral do pescoço permitiu a visualização de diversos nervos cutâneos e musculares do plexo cervical, assim como de alguns de seus ramos e suas relações anatômicas. Também contribuiu para o conhecimento da topografia em que se encontravam tais estruturas e sua organização em camadas. Esse conhecimento anatômico é essencial para a prática médica, tanto clínica quanto cirúrgica.

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“…The collateral branches of the sternothyroid and omohyoid muscles have also been recommended for use in such operations [50]. Prades et al [51] recommend the selection of the common nerve trunk to the sternothyroid and sternohyoid muscle as the prime choice. In 80% of the cases, it was in close proximity to the larynx and corresponded to the size of the recurrent laryngeal nerve.…”

Section: Reviewmentioning

confidence: 99%

Ansa cervicalis: a comprehensive review of its anatomy, variations, pathology, and surgical applications

et al. 2019

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Surgical anatomy of the ansa cervicalis nerve: which branch to use for laryngeal reinnervation in humans?

Abstract: The common trunk of the SHM and STM is the prime choice for laryngeal reinnervation using AC-RLN non-selective anastomosis. If the main trunk is missing, the branch to the STM can be an attractive candidate.

Cited by 15 publications

References 28 publications

Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes

Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes

Dissecção Do Plexo Cervical Na Formação Médica: Aplicabilidades Clínicas E Cirúrgicas

Ansa cervicalis: a comprehensive review of its anatomy, variations, pathology, and surgical applications

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