Department of Otolaryngology Head and Neck Surgery, Kumamoto University, Graduate School of Medicine, Kumamoto, Japan.
Laryngoscope. 2012 Mar;122(3):606-13. doi: 10.1002/lary.22487. Epub 2012 Jan 17.
OBJECTIVES/HYPOTHESIS: To determine whether nimodipine, an L-type voltage-operated calcium channel antagonist that is an accelerator of axonal regeneration following peripheral nerve injury, can expedite reinnervation of denervated rat thyroarytenoid (TA) muscle following nerve-muscle pedicle (NMP) flap implantation.
A quantitative histologic and physiologic assessment of the TA muscle following NMP flap implantation, with or without nimodipine treatment.
Using 72 Wistar rats, we performed a transection on the left recurrent laryngeal nerve, followed by NMP flap implantation. Thirty-six animals received nimodipine treatment (NIMO [+] group), and the remaining 36 animals received no nimodipine treatment (NIMO [-] group). As a control, 18 animals were subjected only to transection of the left recurrent laryngeal nerve. We performed a histologic assessment for muscle area, axon, nerve terminals (NTs), and acetylcholine receptors (AchRs) in the TA muscle and electromyography at 2, 4, and 10 weeks after surgery.
Muscle area, ratio of the number of NTs to that of AchRs (NT/AchR ratio), and evoked action potential in the TA muscle were significantly greater in the NIMO (+) group than in the NIMO (-) group (P < .05) at 4 weeks. At 10 weeks, the NT/AchR ratio was significantly greater in the NIMO (+) group than in the NIMO (-) group (P < .05).
We found that nimodipine accelerated reinnervation of the denervated TA muscle following NMP flap implantation.
目的/假设:确定尼莫地平(一种 L 型电压门控钙通道拮抗剂,可加速周围神经损伤后的轴突再生)是否可以加速去神经大鼠杓状软骨(TA)肌神经肌皮瓣(NMP)植入后的再神经支配。
对 NMP 皮瓣植入后 TA 肌肉进行定量组织学和生理学评估,包括有无尼莫地平治疗。
使用 72 只 Wistar 大鼠,我们切断左侧喉返神经,然后植入 NMP 皮瓣。36 只动物接受尼莫地平治疗(NIMO[+]组),其余 36 只动物未接受尼莫地平治疗(NIMO[-]组)。作为对照,18 只动物仅接受左侧喉返神经切断术。我们对 TA 肌肉的肌肉面积、轴突、神经末梢(NTs)和乙酰胆碱受体(AchRs)进行组织学评估,并在手术后 2、4 和 10 周进行肌电图检查。
在手术后 4 周时,NIMO[+]组的 TA 肌肉的肌肉面积、NTs 与 AchRs 数量的比值(NT/AchR 比值)和诱发动作电位明显大于 NIMO[-]组(P<.05)。在第 10 周时,NIMO[+]组的 NT/AchR 比值明显大于 NIMO[-]组(P<.05)。
我们发现尼莫地平加速了去神经 TA 肌肉的 NMP 皮瓣植入后的再神经支配。