Role of reinnervation in the management of recurrent laryngeal nerve injury: current state and advances

Fancello, Virginia; Nouraei, S.A.R.; Heathcote, Kate

doi:10.1097/moo.0000000000000416

Cited by 28 publications

(42 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous research on neural anastomosis, nerve grafting, and the creation of a laryngeal muscle pedicle were unlikely to restore the targeted movement of the vocal cords because of the misinnervation from strong motor nerves to muscle fibers. [20][21][22] This misinnervation means that the regenerated recurrent laryngeal nerve does not functionally reinnervate the internal laryngeal muscles. Therefore, it is essential to protect the internal laryngeal muscles from atrophy for further restoration of coordinated movement.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Early Internal Laryngeal Muscle Atrophy After Recurrent Laryngeal Nerve Injuries in Rats

Wang

et al. 2020

The Laryngoscope

View full text Add to dashboard Cite

Objectives/Hypothesis: The present study investigated the characteristics of early internal laryngeal muscle atrophy in recurrent laryngeal nerve injury (RLNI) rats. Study Design: To observe the characteristics of early internal laryngeal muscle atrophy post RLNI. Methods: Rats were divided into three groups: sham-operated control group (n = 20), recurrent laryngeal nerve transverse injury group (RLNTI, n = 50), and recurrent laryngeal nerve blunt contusion group (RLNBC, n = 50). Five weeks after RLNI, certain rats were sacrificed weekly, and their laryngeal tissues were harvested. The atrophic features of internal laryngeal muscles were detected using hematoxylin and eosin. NF-κB and MuRF-1 levels were tested using IHC. Results: The atrophic degree and fibrosis of thyroarytenoid, posterior cricoarytenoid, and lateral cricoarytenoid muscles were related to the type of RLNI. The average myofiber cross-sectional areas increased before an obvious decrease in the RLNTI and RLNBC groups. Muscle recovery occurred in the RLNBC group starting 4 weeks after RLNI, but only a weak trend was observed in the RLNTI group in the 5th week. During the muscle atrophy process, MuRF-1 and NF-κB were upregulated early and were maintained at a high level, which showed a trend similar to muscle atrophy. However, NF-κB expression was opposite to MuRF-1 expression and muscle atrophy when the muscles recovered. Conclusion: The atrophy degree of internal laryngeal muscles was associated with the type of RLNI. The NF-κB/MuRF-1 signaling pathway was involved in internal laryngeal muscle atrophy after RLNI, which is different from skeletal muscle after denervation.

show abstract

Section: Discussionmentioning

confidence: 99%

Characteristics of Early Internal Laryngeal Muscle Atrophy After Recurrent Laryngeal Nerve Injuries in Rats

Wang

et al. 2020

The Laryngoscope

View full text Add to dashboard Cite

show abstract

“…Reinnervation techniques are another option and utilize a donor nerve, often the ansa cervicalis, to strive for a reinnervation and improvement in muscle bulk. 13,15 Reinnervation often takes a prolonged period of time prior to an observed benefit and is often combined with a temporary injection medialization. 13 Thus, multiple medialization and reinnervation methods are available to aid in relieving symptoms due to recurrent laryngeal nerve function deficits.…”

Section: Discussionmentioning

confidence: 99%

“…Medialization techniques have the advantage of rapid improvement in patient symptoms. Reinnervation techniques are another option and utilize a donor nerve, often the ansa cervicalis, to strive for a reinnervation and improvement in muscle bulk 13,15 . Reinnervation often takes a prolonged period of time prior to an observed benefit and is often combined with a temporary injection medialization 13 .…”

Section: Discussionmentioning

confidence: 99%

Paraganglioma of the recurrent laryngeal nerve

et al. 2019

View full text Add to dashboard Cite

Paragangliomas of the head and neck are rare, and most frequently benign, slow growing, and nonsecretory. The most frequent locations these tumors arise in the head and neck include the carotid body, jugular bulb, vagus nerve, tympanic branch of the glossopharyngeal nerve, and sympathetic chain. Here we present, to our knowledge, the second reported case of paraganglioma of the recurrent laryngeal nerve. This case is unique given the patient presentation due to ipsilateral vocal fold paralysis, which has not previously been reported, lack of previous surgery, and demonstration of loss of succinate dehydrogenase iron-sulfur subunit B expression.

show abstract

“…Surgical treatment for this condition focuses on static improvement of glottis closure via procedures such as injection laryngoplasty 2 , thyroplasty, or arytenoid adduction 3 . Some reports have described the use of intraoperative anastomoses with the ansa cervicalis, ansa hypoglossi, and phrenic nerve 4 – 7 . However, although laryngeal muscle atrophy could be prevented, vocal fold motor function could not be recovered.…”

Section: Introductionmentioning

confidence: 99%

TrkA inhibitor promotes motor functional regeneration of recurrent laryngeal nerve by suppression of sensory nerve regeneration

Suzuki

Araki

Matsui

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Recurrent laryngeal nerve (RLN) injury, in which hoarseness and dysphagia arise as a result of impaired vocal fold movement, is a serious complication. Misdirected regeneration is an issue for functional regeneration. In this study, we demonstrated the effect of TrkA inhibitors, which blocks the NGF-TrkA pathway that acts on the sensory/automatic nerves thus preventing misdirected regeneration among motor and sensory nerves, and thereby promoting the regeneration of motor neurons to achieve functional recovery. RLN axotomy rat models were used in this study, in which cut ends of the nerve were bridged with polyglycolic acid-collagen tube with and without TrkA inhibitor (TrkAi) infiltration. Our study revealed significant improvement in motor nerve fiber regeneration and function, in assessment of vocal fold movement, myelinated nerve regeneration, compound muscle action potential, and prevention of laryngeal muscle atrophy. Retrograde labeling demonstrated fewer labeled neurons in the vagus ganglion, which confirmed reduced misdirected regeneration among motor and sensory fibers, and a change in distribution of the labeled neurons in the nucleus ambiguus. Our study demonstrated that TrkAi have a strong potential for clinical application in the treatment of RLN injury.

show abstract

Role of reinnervation in the management of recurrent laryngeal nerve injury: current state and advances

Cited by 28 publications

References 38 publications

Characteristics of Early Internal Laryngeal Muscle Atrophy After Recurrent Laryngeal Nerve Injuries in Rats

Characteristics of Early Internal Laryngeal Muscle Atrophy After Recurrent Laryngeal Nerve Injuries in Rats

Paraganglioma of the recurrent laryngeal nerve

TrkA inhibitor promotes motor functional regeneration of recurrent laryngeal nerve by suppression of sensory nerve regeneration

Contact Info

Product

Resources

About