Journal
LARYNGOSCOPE
Volume 128, Issue 3, Pages E117-E122Publisher
WILEY
DOI: 10.1002/lary.27004
Keywords
Laryngeal reinnervation; recurrent laryngeal nerve; vocal fold paralysis
Funding
- University of Michigan Program for Neurology Research and Discovery
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ObjectiveAfter recurrent laryngeal nerve injury (RLN), spontaneous reinnervation of the larynx occurs with input from multiple sources. The purpose of this study was to determine the timing and efficiency of reinnervation across a resected RLN segment in a rat model of RLN injury. Study DesignAnimal study. MethodsTwelve male 60-day-old Sprague Dawley rats underwent resection of a 5-mm segment of the right RLN. Rats were sacrificed at 1, 2, 4, and 12 weeks after nerve injury to harvest the larynx and trachea for immunohistologic analysis. The distal RLN segment was stained with neurofilament, and axons were counted and compared to the nonoperated side. Thyroarytenoid (TA) muscles were stained with alpha-bungarotoxin, synaptophysin, and neurofilament to identify intact neuromuscular junctions (NMJ). The number of intact NMJs from the denervated side was compared to the nonoperated side. ResultsNerve fibers regenerated across the resected RLN gap into the distal recurrent laryngeal nerve to innervate the TA muscle. The number of nerve fibers in the distal nerve segment increased over time and reached the normal number by 12 weeks postdenervation. Axons formed intact neuromuscular junctions in the TA, with 48.8% 16.7% of the normal number of intact NMJs at 4 weeks and 88.3% 30.1% of the normal number by 12 weeks. ConclusionFollowing resection of an RLN segment in a rat model, nerve fibers spontaneously regenerate through the distal segment of the transected nerve and form intact NMJs in order to reinnervate the TA muscle. Level of EvidenceNA. Laryngoscope, 128:E117-E122, 2018
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