Intrinsic laryngeal muscle reinnervation with nerve-muscle pedicle.
OBJECTIVE
To test the application of the nerve-muscle pedicle (NMP) technique for selective reinnervation of previously denervated posterior cricoarytenoid (PCA) muscle.


METHODS
The left recurrent laryngeal nerve (RLN) was severed in 5 mongrel dogs, and an ansa cervicalis-sternohyoid muscle pedicle was sutured to the left PCA muscle. Three dogs underwent a sham operation. Videolaryngoscopy was performed, and electromyographic data were collected after 1 year on average. Finally, histologic analysis of the NMP was performed.


RESULTS
The video records showed the return of mobility of the PCA muscle reinnervated by the NMP. EMG data as to show evoked polyphasic potentials showed also evidence of reinnervation of the PCA muscle. With immunohistochemical reaction (antineurofilament antibody+biotin) we could show neurofilaments and motor endplates in both sides in all 5 animals.


CONCLUSIONS
The NMP technique could eliminate the need for arytenoidectomy and laterofixation in patients with unilateral or bilateral vocal fold paralysis. The quality of life and voice may be improved.
Tóth
Andrea
A
Department of Otolaryngology-Head and Neck Surgery, Medical and Health Science Centre, University of Debrecen, 4012 Debrecen, Nagyerdei krt. 98, Hungary. tot121@hotmail.com
Szucs
Attila
A
Harasztosi
Csaba
C
Matesz
Klára
K
Pucsok
Klára
K
Mikó
Irén
I
Sziklai
István
I
D000818:Animals; D003413:Cricoid Cartilage / Q000294:innervation; D004285:Dogs; D004576:Electromyography; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007821:Laryngeal Muscles / Q000294:innervation*; D008297:Male; D009045:Motor Endplate / Q000378:metabolism; D010525:Peripheral Nerves / Q000637:transplantation*