Reinnervation of the Unilaterally Paralyzed Larynx
Reinnervation of the Unilaterally Paralyzed Larynx
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单侧瘫痪喉的神经再生
DOI：
10.1177/000348947708600612
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发表时间：
1977
期刊：
影响因子：
--
通讯作者：
H. Tucker
中科院分区：
文献类型：
--
作者：
H. Tucker
由于双侧瘫痪喉外展肌神经支配的早期成功，已经在人类患者中进行了实验工作和最终的手术，以努力将相同的基本概念应用于单侧瘫痪喉的神经支配。以与先前报道的方式相同的方式从肩胛舌骨肌获得神经肌肉蒂。甲状腺翼的下 50% 被小心地移出软骨膜外，暴露甲杓肌（主要喉内收肌）的侧向纤维。将先前修复的神经肌肉蒂插入该肌肉中以完成手术。迄今为止，已对 9 个病例进行了该手术，这些病例通常由于伴随的上神经麻痹而感觉声门后裂口的程度太大，无法通过 Teflon® 注射充分控制。所有九个病例都实现了某种程度的自发内收恢复。
Because of early success with reinnervation of the abductor musculature of bilaterally paralyzed larynges, experimental work and ultimately surgery in human patients has been undertaken to endeavor to apply the same basic concept to reinnervation of the unilaterally paralyzed larynx. A nerve-muscle pedicle is obtained from the omohyoid muscle in a manner identical to that previously reported. The lower 50% of the thyroid ala is carefully removed outside the perichondrial envelope and the lateral fibers of the thyroarytenoideus muscle (major laryngeal adductor) is exposed. The previously repaired nerve-muscle pedicle is inserted into this muscle to complete the procedure. The procedure has been undertaken in nine cases to date where the degree of posterior glottic chink, usually because of a concomitant superior nerve paralysis, was felt to be too great to be adequately managed by Teflon® injection. Some degree of spontaneous return of adduction was accomplished in all nine cases.