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喉移植中展肌和内收肌分支的功能鉴定

Functional identification of abductor and adductor branches for laryngeal transplantation.

作者信息

Migacz Ewa, Howard David, Gajewski Zdzisław, Siewruk Katarzyna, Kukwa Wojciech

机构信息

Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, 19/25 Stepinska Street, 00-739, Warsaw, Poland.

Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, London, UK.

出版信息

Eur Arch Otorhinolaryngol. 2018 Nov;275(11):2813-2816. doi: 10.1007/s00405-018-5112-3. Epub 2018 Sep 1.

DOI:10.1007/s00405-018-5112-3
PMID:30173404
Abstract

PURPOSE

This is a feasibility study of functional identification of the abductor and adductor recurrent laryngeal nerve branches, which could be used in the donor's larynx for functional laryngeal transplantation.

METHODS

The study was performed on swine (n = 3) and human (n = 4) models of a donor larynx. The recurrent laryngeal nerve and its branches were found. Using stimulator, abductor and adductor branches were identified, and glottis closing and opening were captured with an endoscope.

RESULTS

The result was positive if two ENT specialists noticed at least one adduction and one abduction movement in the same subject. It was obtained in three out of three swine and three out of four humans.

CONCLUSIONS

This study shows a way of reinnervation of a transplanted larynx which might result in a functional organ. It describes the first step of the procedure: functional identification of the abductor and adductor branches of the recurrent laryngeal nerve in the donor before the larynx is excised for transplantation.

摘要

目的

这是一项关于喉返神经外展支和内收支功能识别的可行性研究,该研究可用于供体喉部的功能性喉移植。

方法

该研究在供体喉部的猪模型(n = 3)和人类模型(n = 4)上进行。找到喉返神经及其分支。使用刺激器识别外展支和内收支,并用内窥镜捕捉声门的闭合和张开。

结果

如果两名耳鼻喉科专家在同一受试者中至少观察到一次内收运动和一次外展运动,则结果为阳性。三只猪中的三只以及四个人中的三个获得了阳性结果。

结论

本研究展示了一种对移植喉进行再神经支配的方法,这可能会产生一个功能正常的器官。它描述了该手术的第一步:在切除喉部进行移植之前,对供体喉返神经的外展支和内收支进行功能识别。

相似文献

1
Functional identification of abductor and adductor branches for laryngeal transplantation.喉移植中展肌和内收肌分支的功能鉴定
Eur Arch Otorhinolaryngol. 2018 Nov;275(11):2813-2816. doi: 10.1007/s00405-018-5112-3. Epub 2018 Sep 1.
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Selective reinnervation of the abductor and adductor muscles of the canine larynx after recurrent nerve paralysis.犬喉返神经麻痹后外展肌和内收肌的选择性再支配
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Reinnervation aspects of laryngeal transplantation.喉移植的神经再支配方面
Eur Arch Otorhinolaryngol. 1998;255(10):515-20. doi: 10.1007/s004050050110.
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Surgical anatomy of the recurrent laryngeal nerve: implications for laryngeal reinnervation.喉返神经的手术解剖学:对喉再支配的影响
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Selective reinnervation of vocal cord adductors in unilateral vocal cord paralysis.单侧声带麻痹中声带内收肌的选择性再支配
Ann Otol Rhinol Laryngol. 1984 Jul-Aug;93(4 Pt 1):351-6. doi: 10.1177/000348948409300414.
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Variability in nerve patterns of the adductor muscle group supplied by the recurrent laryngeal nerve.由喉返神经供应的内收肌组神经模式的变异性。
Laryngoscope. 2005 Feb;115(2):358-62. doi: 10.1097/01.mlg.0000154745.78808.02.
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[Experimental study on delayed reinnervation of laryngeal adductor and abductor].[喉内收肌与外展肌延迟神经再支配的实验研究]
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[Experimental study on simultaneous selective reinnervation of the adductors and the abductor muscle for the treatment of the laryngeal paralysis].[内收肌与外展肌同步选择性再支配治疗喉麻痹的实验研究]
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本文引用的文献

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Current Treatment Options for Bilateral Vocal Fold Paralysis: A State-of-the-Art Review.双侧声带麻痹的当前治疗选择:最新综述
Clin Exp Otorhinolaryngol. 2017 Sep;10(3):203-212. doi: 10.21053/ceo.2017.00199. Epub 2017 Jul 4.
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First Complex Allotransplantation of Neck Organs: Larynx, Trachea, Pharynx, Esophagus, Thyroid, Parathyroid Glands, and Anterior Cervical Wall: A Case Report.首例颈部器官(喉、气管、咽、食管、甲状腺、甲状旁腺和颈前壁)异体复合移植:1 例报告
Ann Surg. 2017 Aug;266(2):e19-e24. doi: 10.1097/SLA.0000000000002262.
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The current status of human laryngeal transplantation in 2017: A state of the field review.
2017年人类喉移植的现状:领域综述
Laryngoscope. 2017 Aug;127(8):1861-1868. doi: 10.1002/lary.26503. Epub 2017 Feb 22.
4
Laryngeal pacing via an implantable stimulator for the rehabilitation of subjects suffering from bilateral vocal fold paralysis: A prospective first-in-human study.通过植入式刺激器进行喉起搏用于双侧声带麻痹患者的康复:一项前瞻性人体首例研究。
Laryngoscope. 2016 Aug;126(8):1810-6. doi: 10.1002/lary.25792. Epub 2015 Nov 24.
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Selective reinnervation for bilateral vocal cord paralysis using the superior laryngeal nerve.使用喉上神经对双侧声带麻痹进行选择性再支配。
Laryngoscope. 2015 Nov;125(11):2547-50. doi: 10.1002/lary.25430. Epub 2015 Jul 7.
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What is the future of 'organ transplantation' in the head and neck?头颈部“器官移植”的未来走向如何?
Curr Opin Otolaryngol Head Neck Surg. 2014 Oct;22(5):429-35. doi: 10.1097/MOO.0000000000000087.
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Reinnervation of bilateral posterior cricoarytenoid muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis.应用左膈神经对双侧声带麻痹患者双侧环杓后肌进行神经再支配。
PLoS One. 2013 Oct 2;8(10):e77233. doi: 10.1371/journal.pone.0077233. eCollection 2013.
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Laryngotracheal transplantation: technical modifications and functional outcomes.喉气管移植:技术改良与功能结局。
Laryngoscope. 2013 Oct;123(10):2502-8. doi: 10.1002/lary.24053. Epub 2013 Mar 11.
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What other journals tell us. Laryngeal transplantation: working party final report, June 2011.其他期刊告诉我们的内容。喉移植:工作组最终报告,2011年6月。
Clin Otolaryngol. 2012 Feb;37(1):53-5. doi: 10.1111/j.1749-4486.2012.02439.x.
10
Laryngeal reinnervation for bilateral vocal fold paralysis.双侧声带麻痹的喉再支配术
Curr Opin Otolaryngol Head Neck Surg. 2011 Dec;19(6):434-8. doi: 10.1097/MOO.0b013e32834c7d30.