Tracheostomy for Long‐Term Laryngeal Experimentation

Dahm, J. David; Paniello, Randal C.

doi:10.1016/s0194-59989870318-3

Cited by 17 publications

(4 citation statements)

References 12 publications

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“…Under general anesthesia, a midline incision exposed the larynx and trachea. A tracheostomy was made between rings 8–12 as previously described 21 . Both RLNs were dissected, fitted with Harvard electrodes, and connected to a custom constant‐current laryngeal nerve stimulator.…”

Section: Methodsmentioning

confidence: 99%

“…A tracheostomy was made between rings 8-12 as previously described. 21 Both RLNs were dissected, fitted with Harvard electrodes, and connected to a custom constantcurrent laryngeal nerve stimulator. Glottic closing force (GCF) was measured as previously described, 22 so that the overall RLN recovery can be compared to previous experiments.…”

Section: Initial Procedure: Baseline Data and Muscle Harvestmentioning

confidence: 99%

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Enhanced Abductor Function in Bilateral Vocal Fold Paralysis with Muscle Stem Cells

et al. 2023

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IntroductionPatients with bilateral vocal fold paralysis (BVFP) experience airway obstruction because of loss of abductor function of posterior cricoarytenoid (PCA) muscles. We previously reported that implantation of autologous muscle progenitor (stem) cells into thyroarytenoid muscles during reinnervation resulted in improved adductor function. In this study, that same approach was applied to treating PCA muscles in a canine model of BVFP.DesignAnimal study.MethodsTwo canines underwent baseline measures of glottal resistance (GR), then complete transection and suture repair of both recurrent laryngeal nerves. Muscle stem cells were isolated from skeletal muscle and cultured. Two months later, GR was measured, and then 107 stem cells were implanted into one PCA muscle of each animal. After four more months, GR and glottal opening force (GOF) were measured and the muscles were harvested for histologic study. One control dog underwent the same procedures without stem cell implantation, for comparison.ResultsGR increased by 21%–25% over baseline at 2 months, but after stem cell implantation, improved to 10%–14% over baseline at 6 months. PCA muscle strength, as determined by GOF, was 61%–65% on control sides (no stem cells), and 78%–83% on treated sides (with stem cells). Histology confirmed survival of stem cells and a 50% higher rate of innervation of motor endplates in the stem cell treated sides.ConclusionAutologous muscle progenitor (stem) cells show promise as a potential new therapy for patients with bilateral vocal fold paralysis. Additional studies are needed to determine the optimal number of cells, timing of implantation, and other variables before launching a clinical trial.Level of EvidenceN/A (animal study) Laryngoscope, 2023

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Section: Methodsmentioning

confidence: 99%

Section: Initial Procedure: Baseline Data and Muscle Harvestmentioning

confidence: 99%

Enhanced Abductor Function in Bilateral Vocal Fold Paralysis with Muscle Stem Cells

et al. 2023

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“…The tracheotomy was matured to a permanent tracheostomy with our previously described method 48 . The stoma does not require a tracheostomy tube, even during the early postoperative period.…”

Section: Methodsmentioning

confidence: 99%

“…The tracheotomy was matured to a permanent tracheostomy with our previously described method. 48 The stoma does not require a tracheostomy tube, even during the early postoperative period. During the first week of healing, the wounds were protected either with a wide leather collar or by wrapping the hind paws with gauze roll bandages to prevent scratching.…”

Section: Surgerymentioning

confidence: 99%

Long‐term model of induced canine phonation

Paniello¹,

Dahm²

1998

Otolaryngol.--head neck surg.

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Experimental induced phonation in the dog has been used in short-term studies by several investigators and has proved quite useful in laryngeal research. In this study a long-term canine phonation model is described that uses permanently implanted electrodes on the superior and recurrent laryngeal nerves. A serial induced phonation model has not been previously reported and is needed for laryngeal research in which voice results are a primary end point. Inexpensive, reliable, nontoxic electrodes were designed and fabricated. The laryngeal nerves were found to be quite susceptible to injury, necessitating a series of changes in electrode design. Electrode durability and laryngeal nerve viability improved with each design modification; the final design gave a recurrent laryngeal nerve viability rate of 100% at 6 weeks, 83% at 9 weeks, and 73% at 12 weeks. Induced phonation was successfully produced on a repeated basis by stimulating the recurrent laryngeal nerves while passing air through the larynx, in 22 (95.6%) of 23 animals. Stimulation of the superior laryngeal nerves increased vocal fold length and tension but was not required for phonation. Technical aspects of chronic implantation and stimulation of the laryngeal nerves are discussed. The development and successful long-term implantation of electrodes on the laryngeal nerves and their use in repeated induced phonation have not been reported previously.

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Laryngeal adductor function in experimental models of recurrent laryngeal nerve injury

2014

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Objectives/Hypothesis Most patients with unilateral vocal fold paralysis experience some degree of spontaneous reinnervation, which depends upon the type and severity of recurrent laryngeal nerve (RLN) injury. After partial recovery, the paretic vocal fold may or may not adduct adequately to allow glottic closure, which in turn affects phonatory and swallowing outcomes. This process was studied in a series of canine laryngeal nerve injury models. Study Design Animal (canine) experiments. Methods Maximum stimulable laryngeal adductor pressure (LAP) was measured pre-treatment (baseline) and at 6 months following experimental RLN injuries (total n=59). The 9 study groups were designed to simulate a range of severities of RLN injury. Results The greatest LAP recovery, at 108% of original baseline, was seen in a 50% transection model; the least recovery was seen when the RLN underwent complete transection with repair, at 56% with precise alignment and 50% with alignment reversed. Intermediate models (partial RLN injuries) gave intermediate results. Crush models recovered 105% of LAP, while a half-transection, half-crush injury recovered 72% and cautery injuries recovered 61%. Controls (complete transection without repair) had no measurable recovery. Conclusions The injured RLN has a strong tendency to recover. Restoration of adductor strength, as determined by the LAP, was predictably related to the severity of RLN injury. The model RLN injuries studied provide a range of expected outcomes that can be used for future experiments exploring interventions that may improve post-injury adductor function.

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Tracheostomy for Long‐Term Laryngeal Experimentation

Cited by 17 publications

References 12 publications

Enhanced Abductor Function in Bilateral Vocal Fold Paralysis with Muscle Stem Cells

Enhanced Abductor Function in Bilateral Vocal Fold Paralysis with Muscle Stem Cells

Long‐term model of induced canine phonation

Laryngeal adductor function in experimental models of recurrent laryngeal nerve injury

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