Maniglia A J, Dodds B, Sorensen K, Katirji M B, Rosenbaum M L
Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, OH.
Ann Otol Rhinol Laryngol. 1989 Nov;98(11):907-9. doi: 10.1177/000348948909801113.
This report analyzes the experience gained using two different techniques to reinnervate the paralyzed vocal cord. In the neurotization group, the superior laryngeal nerve (SLN) motor branch-cricothyroid muscle pedicle was used to reinnervate the posterior cricoarytenoid muscle. In the direct nerve anastomosis group, the SLN was anastomosed to the abductor branch of the recurrent laryngeal nerve (RLN), and the ansa hypoglossi (AH) to the adductor branch of the RLN. A third group of animals (control) had the right RLN sectioned without any anastomosis. About 5 to 6 months postoperatively the animals were killed painlessly and evaluated. The neurotization group revealed vocal fold mobilization on the right side to have an average of about half of the mobility of the left, normal side. After the RLN and SLN on the left were severed as well as the AH bilaterally, the vocal cord mobility was reduced to about one fourth. The direct nerve anastomosis group showed about fourfold less vocal cord mobility than the neurotization group. After the SLN, RLN, and AH were severed bilaterally, the control group showed no vocal cord mobility. The neurotization technique has been selected for further experimentation in human adults.
本报告分析了使用两种不同技术使麻痹声带重新获得神经支配的经验。在神经化组中，采用喉上神经（SLN）运动支 - 环甲肌蒂来使环杓后肌重新获得神经支配。在直接神经吻合组中，将SLN与喉返神经（RLN）的外展支进行吻合，将舌下神经袢（AH）与RLN的内收支进行吻合。第三组动物（对照组）切断右侧RLN，不进行任何吻合。术后约5至6个月，对动物实施无痛处死并进行评估。神经化组显示右侧声带活动度平均约为左侧正常侧的一半。在切断左侧的RLN和SLN以及双侧的AH后，声带活动度降至约四分之一。直接神经吻合组的声带活动度比神经化组少约四倍。在双侧切断SLN、RLN和AH后，对照组显示无声带活动。神经化技术已被选用于在成年人体中进行进一步实验。
