Aoyama Takashi, Kumai Yoshihiko, Yumoto Eiji, Ito Takaaki, Miyamaru Satoru
Department of Otolaryngology-Head and Neck Surgery, Kumamoto University School of Medicine, Kumamoto, Japan.
Ann Otol Rhinol Laryngol. 2010 Dec;119(12):823-9. doi: 10.1177/000348941011901206.
We investigated whether implantation of an ansa cervicalis nerve (ACN)-muscle pedicle into the thyroarytenoid (TA) muscle is efficacious in the presence of partial recurrent laryngeal nerve (RLN) innervation.
We studied a total of 36 rats. Twelve of the rats served as positive and negative control animals. In the remaining 24 rats, the left RLN was transected, a 1-mm piece of nerve was removed, and the stumps were abutted in silicone tubes (STs), inducing partial RLN regeneration. Twelve of the ST-treated rats underwent this procedure alone, and the other 12 rats had a nerve-muscle pedicle (NMP) implanted into the left TA muscle 5 weeks after ST treatment. At 15 weeks, reinnervation was assessed by histologic evaluation of the TA muscle and by electromyography with stimulation of the RLNs and ACNs.
The muscle area, the number of nerve terminals, the number of acetylcholine receptors, and the ratio of nerve terminals to acetylcholine receptors were significantly greater (p < 0.05) in the NMP group than in the ST group. Electromyography elicited TA muscle compound action potentials upon stimulation of the RLNs and ACNs.
In rats, NMP implantation is efficacious for reducing atrophic changes in the TA muscle in the presence of partial RLN innervation.
我们研究了在喉返神经（RLN）部分支配的情况下，将颈襻神经（ACN）-肌肉蒂植入甲杓肌（TA）是否有效。
我们共研究了36只大鼠。其中12只大鼠作为阳性和阴性对照动物。在其余24只大鼠中，切断左侧RLN，切除1毫米长的神经段，将残端对接于硅胶管（ST）中，诱导RLN部分再生。12只接受ST处理的大鼠仅进行此操作，另外12只大鼠在ST处理5周后将神经-肌肉蒂（NMP）植入左侧TA肌。在15周时，通过对TA肌进行组织学评估以及对RLN和ACN进行刺激的肌电图来评估神经再支配情况。
NMP组的肌肉面积、神经末梢数量、乙酰胆碱受体数量以及神经末梢与乙酰胆碱受体的比例均显著大于ST组（p < 0.05）。肌电图显示，刺激RLN和ACN时可诱发TA肌复合动作电位。
在大鼠中，在RLN部分支配的情况下，植入NMP对减少TA肌的萎缩性变化有效。
