Senturk Adem, Harmantepe Ahmet Tarik, Yordanagil Mevlut, Celik Bilgehan, Budak Ozcan, Doganay Songul, Turan Fatih, Canturk Alp Omer, Capoglu Recayi, Mutlu Fuldem
Sakarya University Training and Research Hospital and Department of Surgical Oncology Sakarya Turkey.
Department of General Surgery Sakarya University Faculty of Medicine Sakarya Turkey.
Laryngoscope Investig Otolaryngol. 2025 Mar 19;10(2):e70087. doi: 10.1002/lio2.70087. eCollection 2025 Apr.
Injuries to the recurrent laryngeal nerve (RLN) that may occur during thyroidectomy cause hoarseness, dysphagia, and dyspnea. Even if the injured nerve can be repaired surgically, it heals slowly and not completely. Platelet-rich plasma (PRP) is obtained by centrifuging blood taken from the human body. PRP accelerates the healing of the injured nerve due to the many growth factors it contains. The aim of this study is to investigate the therapeutic effectiveness of PRP and assess surgical repair after RLN injury.
Twenty-eight male Wistar albino rats were used in this study. We divided the rats into four groups, with seven animals in each group. Group 1: RLN was cut and primary repair was performed. Group 2: RLN was cut but not repaired. Group 3: RLN was cut, primary repair was performed, and PRP was injected. Group 4: RLN was cut, and PRP was injected without repair. Laryngoscopy and electromyography (EMG) were conducted before and after the procedure. For histopathological evaluation, parameters such as Schwann cell count, axon damage, and immunohistochemical staining intensity of Ki-67 cell proliferation marker were examined.
The highest amplitudes in EMG were seen in Group 3 rats at the third- and sixth-week postoperatively ( < 0.05). Regarding histopathological evaluation, Schwann cell count, and Ki-67 immunohistochemical staining were primarily observed in Group 3 rats ( < 0.05). Axonal damage and cytoplasmic vacuolization were minimally detected in Group 3 rats ( < 0.05).
In our experimental rodent model, PRP injection increased the Schwann cell count and cell proliferation rate in the injured RLN area by promoting the healing of nerve axons.
甲状腺切除术中可能发生的喉返神经(RLN)损伤会导致声音嘶哑、吞咽困难和呼吸困难。即使受损神经能够通过手术修复,其愈合也缓慢且不完全。富血小板血浆(PRP)是通过离心取自人体的血液获得的。由于PRP含有多种生长因子,它能加速受损神经的愈合。本研究的目的是探讨PRP的治疗效果,并评估RLN损伤后的手术修复情况。
本研究使用了28只雄性Wistar白化大鼠。我们将大鼠分为四组,每组7只动物。第1组:切断RLN并进行一期修复。第2组:切断RLN但不进行修复。第3组:切断RLN,进行一期修复,并注射PRP。第4组:切断RLN,不进行修复并注射PRP。在手术前后进行喉镜检查和肌电图(EMG)检查。为了进行组织病理学评估,检查了雪旺细胞计数、轴突损伤以及Ki-67细胞增殖标志物的免疫组化染色强度等参数。
术后第三周和第六周,第3组大鼠的EMG振幅最高(<0.05)。在组织病理学评估方面,雪旺细胞计数和Ki-67免疫组化染色主要在第3组大鼠中观察到(<0.05)。第3组大鼠中轴突损伤和细胞质空泡化检测最少(<0.05)。
在我们的实验啮齿动物模型中,PRP注射通过促进神经轴突的愈合,增加了受损RLN区域的雪旺细胞计数和细胞增殖率。