Morphologic correlates for laryngeal reinnervation.
OBJECTIVE
To describe morphologic correlates for laryngeal reinnervation.


METHODS
Review of anatomic experiments dealing with laryngeal innervation performed over a 25-year period.


METHODS
Description of results from experimental studies on the cat and human laryngeal muscles and nerve supply.


RESULTS
Despite separation of abductor and adductor laryngeal motor neurons in the central nervous system, the mixture of abductor and adductor axons in the recurrent laryngeal nerve indicates that selective re-innervation of an individual laryngeal muscle must be accomplished at the neuromuscular junction (NMJ) of the muscle. The optimal time for a reinnervating neural source to re-occupy vacated NMJ is at the time of denervation. If the reinnervation procedure is attempted long (>1 mo) after denervation, extraneous end plates of other neural systems must be eliminated to provide vacant NMJ. The nerve muscle pedicle (NMP) concept is an effective model for reinnervation of a laryngeal muscle provided its activity pattern is similar to that of the denervated muscle and its insertion into vacated NMJ is timely.


CONCLUSIONS
NMP offers a logical method for selective laryngeal muscle reinnervation. Critical to the success of NMP are the physiological input to the NMP and timing of NMP implantation.
Gacek
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RR
Division of Otolaryngology-Head & Neck Surgery, University of South Alabama, Mobile, Alabama 36688-0002, USA. rgacek@usamail.usouthal.edu
D000818:Animals; D001369:Axons / Q000502:physiology; D002415:Cats; D003714:Denervation; D006801:Humans; D007821:Laryngeal Muscles / Q000294:innervation*; D007823:Laryngeal Nerves / Q000033:anatomy & histology* / Q000601:surgery; D007830:Larynx / Q000033:anatomy & histology*; D009469:Neuromuscular Junction / Q000601:surgery*; D012009:Recurrent Laryngeal Nerve / Q000033:anatomy & histology* / Q000601:surgery