Spontaneous laryngeal reinnervation following chronic recurrent laryngeal nerve injury

被引:26
作者
Kupfer, Robbi A. [1 ]
Old, Matthew O. [3 ]
Oh, Sang Su [2 ]
Feldman, Eva L. [2 ]
Hogikyan, Norman D. [1 ]
机构
[1] Univ Michigan, Dept Otolaryngol Head & Neck Surg, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Dept Neurol, Ann Arbor, MI 48109 USA
[3] Ohio State Univ, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA
关键词
Laryngeal reinnervation; recurrent laryngeal nerve injury; vocal fold paralysis; superior laryngeal nerve; thyroarytenoid muscle; animal model; THYROARYTENOID MUSCLE; VOCAL CORD; SYNKINESIS; MODEL; ELECTROMYOGRAPHY; INNERVATION; BRANCH; RAT;
D O I
10.1002/lary.24049
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives/Hypothesis To enhance understanding of spontaneous laryngeal muscle reinnervation following severe recurrent laryngeal nerve injury by testing the hypotheses that 1) nerve fibers responsible for thyroarytenoid muscle reinnervation can originate from multiple sources and 2) superior laryngeal nerve is a source of reinnervation. Study Design Prospective, controlled, animal model. Methods A combination of retrograde neuronal labeling techniques, immunohistochemistry, electromyography, and sequential observations of vocal fold mobility were employed in rat model of chronic recurrent laryngeal nerve injury. The current study details an initial set of experiments in sham surgical and denervated group animals and a subsequent set of experiments in a denervated group. Results At 3 months after recurrent laryngeal nerve resection, retrograde brainstem neuronal labeling identified cells in the characteristic superior laryngeal nerve cell body location as well as cells in a novel caudal location. Regrowth of neuron fibers across the site of previous recurrent laryngeal nerve resection was seen in 87% of examined animals in the denervated group. Electromyographic data support innervation by both the superior and recurrent laryngeal nerves following chronic recurrent laryngeal nerve injury. Conclusions Following chronic recurrent laryngeal nerve injury in the rat, laryngeal innervation is demonstrated through the superior laryngeal nerve from cells both within and outside of the normal cluster of cells that supply the superior laryngeal nerve. The recurrent laryngeal nerve regenerates across a surgically created gap, but functional significance of regenerated nerve fibers is unclear.
引用
收藏
页码:2216 / 2227
页数:12
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