Fulton I C, Derksen F J, Stick J A, Robinson N E, Duncan I D
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824-1314.
Am J Vet Res. 1992 Apr;53(4):592-6.
A nerve muscle pedicle (NMP) graft was placed in the cricoarytenoideus dorsalis (CAD) muscle of 6 horses with induced left laryngeal hemiplegia. The NMP graft was created by use of the first cervical nerve and omohyoideus muscle. In 1 horse (control), the first cervical nerve was transected after placement of the NMP graft. One year after the surgical procedure, horses were examined endoscopically and then anesthetized. While the larynx was observed endoscopically, the first cervical nerve was stimulated. Horses were subsequently euthanatized, and the larynx was harvested. Prior to anesthesia, the endoscopic appearance of the larynx of all horses was typical of laryngeal hemiplegia. During anesthesia, stimulation of the first cervical nerve produced vigorous abduction of the left arytenoid in principal horses but not in the control horse. The right cricoarytenoideus lateralis and CAD muscles were grossly and histologically normal. Also, the left cricoarytenoideus lateralis was atrophic in all horses as was the left CAD muscle of the control horse. In contrast, the left CAD muscle harvested from principal horses had evidence of reinnervation with type 1 or type 2 fiber grouping. One year after the NMP graft procedure, horses with left laryngeal hemiplegia had reinnervation of the left CAD muscle. In another study, reinnervation was sufficient to allow normal laryngeal function during exercise. Combined, these data suggest that the NMP graft procedure is a viable technique for the treatment of left laryngeal hemiplegia in horses.
将神经肌肉蒂（NMP）移植物植入6匹诱发左喉偏瘫的马的环杓后肌（CAD）中。NMP移植物通过使用第一颈神经和肩胛舌骨肌制作而成。在1匹马（对照组）中，NMP移植物植入后切断第一颈神经。手术一年后，对马进行内镜检查，然后实施麻醉。在内镜观察喉部的同时，刺激第一颈神经。随后对马实施安乐死，并摘取喉部。麻醉前，所有马的喉部内镜表现均为典型的喉偏瘫。麻醉期间，刺激第一颈神经使主要实验马的左杓状软骨有力外展，而对照组马则无此表现。右侧环杓侧肌和CAD肌肉在大体和组织学上均正常。此外，所有马的左环杓侧肌均萎缩，对照组马的左CAD肌肉也萎缩。相比之下，主要实验马摘取的左CAD肌肉有1型或2型纤维群组再支配的证据。NMP移植物手术后一年，左喉偏瘫的马的左CAD肌肉实现了再支配。在另一项研究中，再支配足以使运动期间喉部功能正常。综合这些数据表明，NMP移植物手术是治疗马左喉偏瘫的一种可行技术。
