Broniatowski M, Olsen E, Davies C, Benninger M, Jacobs G, Tucker H, Nosé Y
St. Vincent Charity Hospital and Health Center, Cleveland, Ohio 44115.
ASAIO Trans. 1989 Jul-Sep;35(3):487-9. doi: 10.1097/00002480-198907000-00102.
Previous attempts at laryngeal transplantation have failed because the grafted organ could not be dynamically rehabilitated. Nerve-muscle pedicles were used to reinnervate each of the principal intrinsic laryngeal muscles in 20 dogs after autotransplantation with conservation of the essential nutrient vessels. Afferent information obtained by sensors fixed to the chest (a strain gauge and transthoracic impedance electrode) was channeled to an electronic package for coordinated stimulation of pedicles reinnervating the posterior cricoartenoideus (opening), the cricothyroideus (elongation) and the thyroarytenoideus (closure of the vocal cords) by perineural electrodes. Corresponding vocal cord motion was videotaped on the same screen as sensor displacements and stimulating currents (approximately 2 V, 60 Hz, and 4 msec pulse width). Clear responses were recorded in all evaluable animals (n = 8), but contraction was stronger with longer reinnervation time (3-7 weeks). Based on this feasibility study, chronic experiments are planned that will set the ground work for possible future human laryngeal transplantation.
以往的喉移植尝试均告失败，原因是移植器官无法实现动态修复。在20只犬自体移植且保留重要营养血管后，使用神经肌肉蒂对每一块主要的喉内肌进行再支配。通过固定在胸部的传感器（应变片和经胸阻抗电极）获取的传入信息被传输到一个电子组件，以便通过神经周围电极对支配环杓后肌（张开）、环甲肌（拉长）和甲杓肌（声带闭合）的蒂进行协调刺激。相应的声带运动与传感器位移和刺激电流（约2V、60Hz和4毫秒脉冲宽度）在同一屏幕上被录像。在所有可评估的动物（n = 8）中均记录到了明显的反应，但再支配时间较长（3 - 7周）时收缩更强。基于这项可行性研究，计划开展慢性实验，为未来可能的人类喉移植奠定基础。
