Motion-specific laryngeal reinnervation using muscle-nerve-muscle neurotization.
There is no current treatment method that can reliably restore physiologic movement to a paralyzed vocal fold. The purposes of this study were to test the hypotheses that 1) muscle-nerve-muscle (M-N-M) neurotization can be induced in feline laryngeal muscles and 2) M-N-M neurotization can restore movement to a paralyzed vocal fold. Muscle-nerve-muscle neurotization can be defined as the reinnervation of a denervated muscle via axons that are induced to sprout from nerves within an innervated muscle and that then traverse a nerve graft interposed between it and the target denervated muscle. A paralyzed laryngeal muscle could be reinnervated by axons from its contralateral paired muscle, thus achieving motion-specific reinnervation. Eighteen adult cats were divided into sham, hemilaryngeal-denervated, and M-N-M-reinnervated thyroarytenoid muscle groups. Five of the 6 reinnervated animals had histologic evidence of axons in the nerve graft, 4 of the 6 had evoked electromyographic evidence of crossed reinnervation, and 1 of the 6 had a return of appropriately phased adduction. This technique has great potential and should be further investigated.
Hogikyan
N D
ND
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor 48109-0312, USA.
Johns
M M
MM
Kileny
P R
PR
Urbanchek
M
M
Carroll
W R
WR
Kuzon
W M
WM
D000818:Animals; D002415:Cats; D004576:Electromyography; D007821:Laryngeal Muscles / Q000294:innervation / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007823:Laryngeal Nerves / Q000601:surgery* / Q000637:transplantation*; D007828:Laryngoscopy; D009038:Motion; D009068:Movement; D009121:Muscle Denervation; D014826:Vocal Cord Paralysis / Q000601:surgery*