Laryngeal Adductor Function in Experimental Models of Recurrent Laryngeal Nerve Injury
Laryngeal Adductor Function in Experimental Models of Recurrent Laryngeal Nerve Injury
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DOI：
10.1002/lary.24947
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发表时间：
2015-02-01
期刊：
影响因子：
2.6
通讯作者：
Debnath, Nick L.
中科院分区：
文献类型：
--
作者：
Paniello, Randal C.;Rich, Jason T.;Debnath, Nick L.
目的/假设：大多数单侧声带麻痹的患者都会经历某种程度的自发性神经再支配，这取决于喉返神经（RLN）损伤的类型和严重程度。部分恢复后，麻痹声带可能会或可能不会充分内收，以允许声门关闭，这反过来又影响发音和吞咽的结果。在一系列犬喉神经损伤models.Study设计：动物（犬）experiments.Methods：最大可刺激喉内收肌压力（ESTA）进行了研究，在预处理（基线）和6个月后，实验性喉返神经损伤（总n=59）。九个研究组的设计，以模拟一系列的严重程度的喉返神经injure.Results：最大的恢复，在108%的原始基线，被认为是在50%的横断模型;最少的恢复，看到喉返神经进行完全横断修复时，在56%与精确对齐和50%与对齐逆转。中间模型（部分喉返神经损伤）给出了中间结果。挤压模型恢复了105%，而半横断，半挤压损伤恢复了72%，烧灼损伤恢复了61%。对照组（完全横断而不修复）没有可测量的recovery.Conclusions：受伤的喉返神经有很强的恢复趋势。恢复内收肌的力量，由脊髓，是可预见的相关的RLN损伤的严重程度。研究的喉返神经损伤模型提供了一系列预期的结果，可用于未来的实验，探索可能改善损伤后内收肌功能的干预措施。
Objectives/Hypothesis: Most patients with unilateral vocal fold paralysis experience some degree of spontaneous reinnervation, which depends upon the type and severity of recurrent laryngeal nerve (RLN) injury. After partial recovery, the paretic vocal fold may or may not adduct adequately to allow glottic closure, which in turn affects phonatory and swallowing outcomes. This process was studied in a series of canine laryngeal nerve injury models.Study Design: Animal (canine) experiments.Methods: Maximum stimulable laryngeal adductor pressure (LAP) was measured pretreatment (baseline) and at 6 months following experimental RLN injuries (total n=59). The nine study groups were designed to simulate a range of severities of RLN injury.Results: The greatest LAP recovery, at 108% of original baseline, was seen in a 50% transection model; the least recovery was seen when the RLN underwent complete transection with repair, at 56% with precise alignment and 50% with alignment reversed. Intermediate models (partial RLN injuries) gave intermediate results. Crush models recovered 105% of LAP, whereas a half-transection, half-crush injury recovered 72%, and cautery injuries recovered 61%. Controls (complete transection without repair) had no measurable recovery.Conclusions: The injured RLN has a strong tendency to recover. Restoration of adductor strength, as determined by the LAP, was predictably related to the severity of RLN injury. The model RLN injuries studied provide a range of expected outcomes that can be used for future experiments exploring interventions that may improve postinjury adductor function.