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Short-term laryngeal electromyography and histopathological findings after primary reconstruction of the inferior laryngeal nerve in rabbits: prospective study

Published online by Cambridge University Press:  20 November 2012

A Dalgic ,
T Kandogan ,
M Koc ,
C Ahmet Kulan ,
A Yagci ,
O Engin ,
G Aksoy  and
M Ziya Ozuer
A Dalgic
Affiliation:
Department of Otolaryngology, Izmir Teaching Hospital, Turkey
T Kandogan*
Affiliation:
Department of Otolaryngology, Izmir Teaching Hospital, Turkey
M Koc
Affiliation:
Department of Otolaryngology, Izmir Teaching Hospital, Turkey
C Ahmet Kulan
Affiliation:
Department of Neurology, Izmir Teaching Hospital, Turkey
A Yagci
Affiliation:
Department of Pathology, Izmir Teaching Hospital, Turkey
O Engin
Affiliation:
Department of Surgery, Izmir Teaching Hospital, Turkey
G Aksoy
Affiliation:
Department of Otolaryngology, Izmir Teaching Hospital, Turkey
M Ziya Ozuer
Affiliation:
Department of Otolaryngology, Izmir Teaching Hospital, Turkey
*
Address for correspondence: Dr Tolga Kandogan, Department of Otolaryngology, Izmir Teaching Hospital, Izmir, Turkey E-mail: [email protected]
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Abstract

Introduction:

The recurrent laryngeal nerve can be injured during surgery. This study investigated recurrent laryngeal nerve reinnervation.

Objective:

To study the short-term effects of primary anastomosis of the recurrent laryngeal nerve, by laryngeal electromyography and histopathological analysis, in a rabbit model.

Method:

Twenty Zealand rabbits underwent either right recurrent laryngeal nerve (1) transection with excision of 1 cm or (2) transection and end-to-end primary anastomosis. Vocal fold movements, laryngeal electromyography results and histological changes were recorded.

Results:

Vocal fold analysis showed a paramedian vocal fold in both groups, with perceptible vibratory movements in group two. Electromyography revealed total denervation potentials in group one, but denervation and regeneration signs in group two. Histopathologically, hyperkeratosis and parakeratosis of the vocal fold mucosa were seen in group one, and signs of parakeratosis and hyperplasia in group two.

Conclusion:

Even under ideal conditions for primary recurrent laryngeal nerve anastomosis, a return to normal muscle function is unlikely. However, such anastomosis prevents muscle atrophy, and should be performed as soon as possible. The degree of nerve recovery is associated with the number, amplitude and myelination level of fibrils returning to the original motor end-plaque.

Keywords

Recurrent Laryngeal NerveVocal Cord ParalysisRabbitElectromyographyPathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 1 , January 2013 , pp. 48 - 53
Copyright
Copyright © JLO (1984) Limited 2012

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References

1 Tessema, B, Pitman, MJ, Roark, RM, Berzofsky, C, Sharma, S, Schaefer, SD. Evaluation of functional recovery of recurrent laryngeal nerve using transoral laryngeal bipolar electromyography: a rat model. Ann Otol Rhinol Laryngol 2008;117:604–8CrossRefGoogle ScholarPubMed
2 Meller, SM. Functional anatomy of the larynx. Otolaryngol Clin North Am 1984;17:3–12 CrossRefGoogle ScholarPubMed
3 Petcu, LG, Sasaki, CT. In: Ballenger, JJ, ed. Diseases of the Nose, Throat, Ear, Head and Neck, 14th edn. Philadelphia: Lea and Febier, 1991;478–97Google Scholar
4 Kaya, S. Diseases of the Larynx. Ankara: Scientific Medical Publications, 2002:19–20 Google Scholar
5 Ioachim, E, Assimakopoulos, D, Goussia, AC, Peschos, D, Skevas, A, Agnantis, NJ. Glycoprotein CD44 expression in benign, premalignant and malignant epithelial lesions of the larynx: an immunohistochemical study including correlation with Rb, p53, Ki-67 and PCNA. Histol Histopathol 1999;14:1113–18Google ScholarPubMed
6 Mu, L, Yang, S. A new method of placement of a needle electrode in the posterior cricoarytenoid muscle for electromyography. Laryngoscope 1990;100:1127–31CrossRefGoogle ScholarPubMed
7 Maronian, NC, Robinson, L, Waugh, P, Hillel, AD. A new electromyographic definition of laryngeal synkinesis. Ann Otol Rhinol Laryngol 2004;113:877–86CrossRefGoogle ScholarPubMed
8 Crumley, RL, McCabe, B. Regeneration of the recurrent laryngeal nerve. Otolaryngol Head Neck Surg 1982;90:442–7CrossRefGoogle ScholarPubMed
9 Siribodhi, C, Sundmaker, W, Atkins, JP, Bonner, FJ. Electromyographic studies of laryngeal paralysis and regeneration of laryngeal motor nerves in dogs. Laryngoscope 1963;73:148–63CrossRefGoogle Scholar
10 Crumley, RL. Laryngeal synkinesis revisited. Ann Otol Rhinol Laryngol 2000;109:365–71CrossRefGoogle ScholarPubMed
11 Flint, PW, Downs, DH, Coltrera, MD. Laryngeal synkinesis following reinnervation in the rat. Neuroanatomic and physiologic study using retrograde fluorescent tracers and electromyography. Ann Otol Rhinol Laryngol 1991;100:797–806 CrossRefGoogle ScholarPubMed
12 Dedo, HH. Electromyographic and visual evaluation of recurrent laryngeal nerve anastomosis in dogs. Ann Otol Rhinol Laryngol 1971;80:664–8CrossRefGoogle ScholarPubMed
13 Norris, CM, Peale, AR. Keratosis of the larynx. J Laryngol Otol 1963;77:635–47CrossRefGoogle ScholarPubMed
14 Rosen, CA. Benign vocal fold lesions and phonomicrosurgery. In: Bailey, BJ, Johnson, JT, Newlands, SD, eds. Head and Neck Surgery – Otolaryngology. Philadelphia: Lippincott Williams & Wilkins, 2006;837–8Google Scholar
15 Hiroto, I, Hirano, M, Tomita, H. Electromyographic investigation of human vocal cord paralysis. Ann Otol Rhinol Laryngol 1968;77:296–304 CrossRefGoogle Scholar
16 Ushio, H. Clinical and experimental studies on recurrent laryngeal nerve paralysis. Part 1. Clinical studies (No. 3). Comparison of phonation ability between end-to-end anastomosis of severed unilateral recurrent laryngeal nerve. J Jpn Surg Soc 1982;83:425–33Google Scholar
17 Crumley, RL. Experiments in reinnervation. Laryngoscope 1982;92:1–27 CrossRefGoogle ScholarPubMed
18 Hirano, M, Nozoe, I, Shin, T, Maeyama, T. Electromyography for laryngeal paralysis. In: Hirano, M, Kirchner, JA, Bless, DM, eds. Neurolaryngology: Recent Advances. Boston: College Hill Press, 1987;232–48Google Scholar
19 Lewis, WS, Crumley, RL, Blanks, RH, Pitcock, JK. Does intralaryngeal motor nerve sprouting occur following unilateral recurrent laryngeal nerve paralysis? Laryngoscope 1991;101:1259–63CrossRefGoogle ScholarPubMed
20 Shindo, ML, Herzon, GD, Hanson, DG, Cain, DJ, Shagal, V. Effects of denervation on laryngeal muscles: a canine model. Laryngoscope 1992;102:663–9CrossRefGoogle ScholarPubMed
21 Netterville, JL, Stone, RE, Rainey, C, Zealear, DL, Ossof, RH. Recurrent laryngeal nerve avulsion for treatment of spastic dysphonia. Ann Otol Rhinol Laryngol 1991;100:10–14 CrossRefGoogle ScholarPubMed
22 Damrose, EJ, Huang, RY, Blumin, JH, Blackwell, KE, Sercarz, JA, Berke, GS. Lack of evoked laryngeal electromyography response in patients with a clinical diagnosis of vocal cord paralysis. Ann Otol Rhinol Laryngol 2001;110:815–19CrossRefGoogle ScholarPubMed
23 Blitzer, AB, Jahn, AF, Keidar, A. Semon's law revisited: an electromyographic analysis of laryngeal synkinesis. Ann Otol Rhinol Laryngol 1996;105:764–9CrossRefGoogle ScholarPubMed
24 Rodgers, BJ, Abdul-Karim, FW, Strauss, M. Histological study of injected autologous fascia in the paralyzed canine vocal fold. Laryngoscope 2000;110:2012–15CrossRefGoogle ScholarPubMed
25 Renne, RA, Gideon, KM. Types and patterns of response in the larynx following inhalation. Toxicol Pathol 2006;34:281–5CrossRefGoogle ScholarPubMed
26 Garcia, I, Krishna, P, Rosen, CA. Severe laryngeal hyperkeratosis secondary to laryngopharyngeal reflux. Ear Nose Throat J 2006;85:417CrossRefGoogle Scholar
27 Bridger, GP. Unilateral laryngeal palsy. A histopathological study. J Laryngol Otol 1977;91:303–7CrossRefGoogle ScholarPubMed
28 Quiney, RE, Michaels, L. Histopathology of vocal cord palsy from recurrent laryngeal nerve damage. J Otolaryngol 1990;19:237–41Google ScholarPubMed
29 Hartl, DM, Brasnu, D. Recurrent laryngeal nerve paralysis: current knowledge and treatment. Ann Otolaryngol Chir Cervicofac 2000;117:60–84 Google ScholarPubMed
30 Thomusch, O, Machens, A, Sekulla, C, Ukkat, J, Lippert, H, Gastinger, I et al. Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: prospective multicenter study in Germany. World J Surg 2000;24:1335–41CrossRefGoogle ScholarPubMed
31 Srirompotong, S, Sae-Seow, P, Srirompotong, S. The cause and evaluation of unilateral vocal cord paralysis. J Med Assoc Thai 2001;84:855–8Google ScholarPubMed
32 Khan, A, Pearlman, RC, Bianchi, DA, Hauck, KW. Experience with two types of electromyography monitoring electrodes during thyroid surgery. Am J Otolaryngol 1997;18:99–102 CrossRefGoogle ScholarPubMed