An experimental comparison of different kinds of laryngeal muscle reinnervation

Zheng, Hongliang; Zhou, Shui‐Hong; Chen, Shicai; Li, Zhaoji; Cuan, Yi

doi:10.1016/s0194-5998(98)70122-6

Cited by 32 publications

(7 citation statements)

References 19 publications

(62 reference statements)

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“…The first important factor that may have influenced the outcome of surgery is the interval between the phrenic nerve transfer procedure and the onset of bilateral RLN injury. Theoretically, better results of reinnervation surgery are obtained if the interval between the injury and reinnervation is shorter, as is shown both in the literature and in our experimental study [6,30]. We performed the phrenic nerve transfer surgery for some BVFP patients with thyroid surgery-related RLN injury within 6 months after the injury, there are some reasons.…”

Section: Discussionmentioning

confidence: 60%

Reinnervation of Bilateral Posterior Cricoarytenoid Muscles Using the Left Phrenic Nerve in Patients with Bilateral Vocal Fold Paralysis

Chen

Zheng

et al. 2013

PLoS ONE

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ObjectiveTo evaluate the feasibility, effectiveness, and safety of reinnervation of the bilateral posterior cricoarytenoid (PCA) muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis.MethodsForty-four patients with bilateral vocal fold paralysis who underwent reinnervation of the bilateral PCA muscles using the left phrenic nerve were enrolled in this study. Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time, pulmonary function testing, and laryngeal electromyography were performed preoperatively and postoperatively. Patients were followed-up for at least 1 year after surgery.ResultsVideostroboscopy showed that within 1 year after reinnervation, abductive movement could be observed in the left vocal folds of 87% of patients and the right vocal folds of 72% of patients. Abductive excursion on the left side was significantly larger than that on the right side (P < 0.05); most of the vocal function parameters were improved postoperatively compared with the preoperative parameters, albeit without a significant difference (P > 0.05). No patients developed immediate dyspnea after surgery, and the pulmonary function parameters recovered to normal reference value levels within 1 year. Postoperative laryngeal electromyography confirmed successful reinnervation of the bilateral PCA muscles. Eighty-seven percent of patients in this series were decannulated and did not show obvious dyspnea after physical activity. Those who were decannulated after subsequent arytenoidectomy were not included in calculating the success rate of decannulation.ConclusionsReinnervation of the bilateral PCA muscles using the left phrenic nerve can restore inspiratory vocal fold abduction to a physiologically satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity.

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Section: Discussionmentioning

confidence: 60%

Reinnervation of Bilateral Posterior Cricoarytenoid Muscles Using the Left Phrenic Nerve in Patients with Bilateral Vocal Fold Paralysis

Chen

Zheng

et al. 2013

PLoS ONE

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“…The main disadvantage of 1) and 2) is the possibility of laryngeal spasm due to misdirected regeneration of the abductor and adductor fibers. Our previous study demonstrated that nerve implantation, neuromuscular pedicle and neurorrhaphy achieved various degrees of reinnervation, with neurorrhaphy showing the best performance [16]. A single branch of ansa cervicalis was recommended to anastomose with RLN for treating UVFP by Crumley and other investigators [8], [9], [10], [11].…”

Section: Discussionmentioning

confidence: 99%

“…A single branch of ansa cervicalis was recommended to anastomose with RLN for treating UVFP by Crumley and other investigators [8], [9], [10], [11]. However, not all axons of nerve have the regenerative capacity to pass through the anastomosis site; nerve transfer requires a sufficient number of axons to reach the paralyzed laryngeal muscle and produce adequate reinnervation for muscular contraction [16]. Thus, Paniello recommended hypoglossal nerve as a donor nerve for anastomosis to RLN, because it has an advantage over Crumely's procedure, that is the hypoglossal nerve contains more axons than ansa cervicalis [19].…”

Section: Discussionmentioning

confidence: 99%

“…We firstly reported laryngeal reinnervation using main branch of ansa cervicalis in UVFP animal models in 1996, and satisfactory or good voice qualities were obtained by this procedure in a small sample of patients with UVFP [14], [16], [17]. The main branch of ansa cervicalis in our procedure possesses more motor fibers than a single branch.…”

Section: Introductionmentioning

confidence: 88%

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Laryngeal Reinnervation Using Ansa Cervicalis for Thyroid Surgery-Related Unilateral Vocal Fold Paralysis: A Long-Term Outcome Analysis of 237 Cases

Wang

Chen

et al. 2011

PLoS ONE

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ObjectiveTo evaluate the long-term efficacy of delayed laryngeal reinnervation using the main branch of the ansa cervicalis in treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery.Summary of Background DataUVFP remains a serious complication of thyroid surgery. Up to now, a completely satisfactory surgical treatment of UVFP has been elusive.MethodsFrom Jan. 1996 to Jan. 2008, a total of 237 UVFP patients who underwent ansa cervicalis main branch-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled as UVFP group; another 237 age- and gender-matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and electromyography were performed preoperatively and postoperatively. The mean follow-up period was 5.2±2.7 years, ranging from 2 to 12 years.ResultsAnalysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved in the UVFP group (P<0.001, postoperative vs. preoperative). The postoperative parameters of vocal function were also significantly improved in the UVFP group (P<0.001) and showed no statistical differences compared to the control group (P>0.05, respectively). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle.ConclusionsDelayed laryngeal reinnervation with the main branch of ansa cervicalis is a feasible and effective approach for treatment of thyroid surgery-related UVFP; it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality.

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“…Previous experimental results have demonstrated that EMG is useful for evaluating the degree of nerve regeneration ( 34 ), as the amplitude correlates with the number of muscle fibers. If a nerve is injured, some nerve fibers will be unable to transmit the nerve impulse, and the amplitude and latency will be affected ( 35 – 38 ).…”

Section: Discussionmentioning

confidence: 99%

Laminin‑chitosan‑PLGA conduit co‑transplanted with Schwann and neural stem cells to repair the injured recurrent laryngeal nerve

Yang

Men

et al. 2018

Exp Ther Med

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The aim of the present study was to assess the possibility and efficacy of utilizing a laminin-chitosan-poly (lactic-co-glycolic acid), otherwise known as laminin-chitosan-PLGA, nerve conduit with the co-transplantation of Schwann and neural stem cells to repair peripheral nerve defects. Previous in vitro experiments have demonstrated that the three-dimensional structure of the built in fiber filament electrospinning of laminin-chitosan-PLGA nerve conduit is beneficial to the migration and regeneration of nerve cells, and has notable mechanical strength and plasticity. It is able to provide support in the neural tissue regeneration process, and has the ability to degrade itself once peripheral nerves complete their regeneration, providing more advantages than other biological and synthetic materials. In the present study, 132 female Sprague Dawley rats were used to establish an animal model of laryngeal nerve injury, and the rats were randomly divided into six groups for experimentation. The nerve conduit was prepared and co-cultured with Schwann and neural stem cells, and micro-surgical techniques were used to repair the 5-mm-long recurrent laryngeal nerve injuries. Functional and histological assessments were performed at 8 and 12 weeks post-surgery, respectively. The results revealed that the laminin-chitosan-PLGA nerve conduit combined with Schwann and neural stem cells was able to promote nerve regeneration (P<0.05), and its effect was superior to those of the autograft (P<0.05). The results of the present study suggest that this is the ideal method for repairing peripheral nerve defects, and cells in the graft may promote nerve regeneration.

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An experimental comparison of different kinds of laryngeal muscle reinnervation

Cited by 32 publications

References 19 publications

Reinnervation of Bilateral Posterior Cricoarytenoid Muscles Using the Left Phrenic Nerve in Patients with Bilateral Vocal Fold Paralysis

Reinnervation of Bilateral Posterior Cricoarytenoid Muscles Using the Left Phrenic Nerve in Patients with Bilateral Vocal Fold Paralysis

Laryngeal Reinnervation Using Ansa Cervicalis for Thyroid Surgery-Related Unilateral Vocal Fold Paralysis: A Long-Term Outcome Analysis of 237 Cases

Laminin‑chitosan‑PLGA conduit co‑transplanted with Schwann and neural stem cells to repair the injured recurrent laryngeal nerve

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