Fata J J, Malmgren L T, Gacek R R, Dum R, Woo P
Department of Otolaryngology and Communication Sciences, State University of New York, Syracuse.
Ann Otol Rhinol Laryngol. 1987 Sep-Oct;96(5):479-87. doi: 10.1177/000348948709600501.
Reinnervation of the posterior cricoarytenoid (PCA) muscle with a nerve-muscle pedicle (NMP) has been proposed for patients with bilateral abductor vocal cord paralysis. Since its success has been controversial, a glycogen depletion histochemical technique was used to examine reinnervation. An ansa cervicalis NMP was implanted into the denervated PCA in nine cats. Eight months later, vocal cord activity was evaluated. The NMP nerve was stimulated extensively in seven cats (experimental group). Optical densities of NMP-supplied PCA muscle fibers from experimental and control groups were compared to detect differences in glycogen content. The results demonstrated quantitative evidence of reinnervation in two experimental animals. Electrical stimulation of the NMP produced abduction in one of these two animals, but was never observed during spontaneous respiration or airway occlusion. These observations indicate that reinnervation can occur but abduction requires electrical stimulation. The NMP technique may be more successful with an electrical pacer.
对于双侧声带外展麻痹患者，有人提出采用神经肌肉蒂（NMP）对环杓后肌（PCA）进行再神经支配。由于其成功率存在争议，因此采用糖原耗竭组织化学技术来检查再神经支配情况。将颈袢NMP植入9只猫的失神经支配的PCA中。8个月后，评估声带活动。对7只猫（实验组）的NMP神经进行广泛刺激。比较实验组和对照组中由NMP供应的PCA肌纤维的光密度，以检测糖原含量的差异。结果显示，在两只实验动物中存在再神经支配的定量证据。对这两只动物中的一只进行NMP电刺激可产生外展，但在自主呼吸或气道阻塞期间从未观察到。这些观察结果表明，再神经支配可以发生，但外展需要电刺激。使用电起搏器时，NMP技术可能会更成功。
