Dalgic A, Kandogan T, Koc M, Kulan C Ahmet, Yagci A, Engin O, Aksoy G, Ozuer M Ziya
Department of Otolaryngology, Izmir Teaching Hospital, Turkey.
J Laryngol Otol. 2013 Jan;127(1):48-53. doi: 10.1017/S0022215112002381. Epub 2012 Nov 20.
The recurrent laryngeal nerve can be injured during surgery. This study investigated recurrent laryngeal nerve reinnervation.
To study the short-term effects of primary anastomosis of the recurrent laryngeal nerve, by laryngeal electromyography and histopathological analysis, in a rabbit model.
Twenty Zealand rabbits underwent either right recurrent laryngeal nerve (1) transection with excision of 1 cm or (2) transection and end-to-end primary anastomosis. Vocal fold movements, laryngeal electromyography results and histological changes were recorded.
Vocal fold analysis showed a paramedian vocal fold in both groups, with perceptible vibratory movements in group two. Electromyography revealed total denervation potentials in group one, but denervation and regeneration signs in group two. Histopathologically, hyperkeratosis and parakeratosis of the vocal fold mucosa were seen in group one, and signs of parakeratosis and hyperplasia in group two.
Even under ideal conditions for primary recurrent laryngeal nerve anastomosis, a return to normal muscle function is unlikely. However, such anastomosis prevents muscle atrophy, and should be performed as soon as possible. The degree of nerve recovery is associated with the number, amplitude and myelination level of fibrils returning to the original motor end-plaque.
喉返神经在手术过程中可能会受到损伤。本研究对喉返神经再支配进行了调查。
通过喉肌电图和组织病理学分析，研究兔模型中喉返神经一期吻合的短期效果。
20只新西兰兔接受以下两种手术之一：（1）右侧喉返神经横断并切除1厘米；（2）右侧喉返神经横断并一期端端吻合。记录声带运动、喉肌电图结果和组织学变化。
声带分析显示两组均为声带旁正中位，第二组有声带可察觉的振动运动。肌电图显示第一组为完全失神经电位，而第二组有失神经和再生迹象。组织病理学上，第一组可见声带黏膜角化过度和不全角化，第二组可见不全角化和增生迹象。
即使在喉返神经一期吻合的理想条件下，肌肉功能也不太可能恢复正常。然而，这种吻合可防止肌肉萎缩，应尽早进行。神经恢复程度与返回原运动终板的纤维数量、振幅和髓鞘化水平有关。
