Preserved regeneration and functional recovery of the injured recurrent laryngeal nerve after secondary surgical repair in adult rats.
OBJECTIVE
Transection of the recurrent laryngeal nerve (RLN) is accompanied by poor functional recovery, despite primary repair, because of regeneration difficulties. Nimodipine can promote regeneration, but it is not yet clear whether preoperative treatment is necessary. It is also not clear whether surgical repair following RLN injury may be performed in a second procedure, with preserved regeneration. This study investigated the time window for secondary surgical repair of the transected RLN and the need for preoperative administration of nimodipine.


METHODS
In adult rats, the left RLN was transected and repaired at time intervals up to 3 weeks after transection, in combination with nimodipine treatment starting either before or after the operation. Regeneration and neuromuscular recovery were assessed by electrophysiology, retrograde tracing, and immunohistochemistry.


RESULTS
Similar (whether 0, 2, or 7 days) regenerative results were obtained when the RLN was repaired up to 1 week after injury, given nimodipine administration, whereas fewer motor neurons managed to regenerate after nerve repair at 3 weeks after the initial transection. No beneficial effect was detected from preoperative nimodipine administration.


CONCLUSIONS
Provided that nimodipine is administered, surgical reconstruction of the RLN can be performed within 1 week after the initial nerve trauma, with preserved neuromuscular function. Nimodipine may be administered at the time of RLN transection injury.
Hydman
Jonas
J
Department of Clinical Neuroscience, Section of Neurosurgery, Karolinska Institutet, Stockholm, Sweden.
Mattsson
Per
P
D000818:Animals; D005260:Female; D011183:Postoperative Complications; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function; D012009:Recurrent Laryngeal Nerve / Q000502:physiology / Q000601:surgery; D061226:Recurrent Laryngeal Nerve Injuries; D012038:Regeneration / Q000502:physiology*