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- Hydman, J, et al.
(författare)
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Diagnosis and prognosis of iatrogenic injury of the recurrent laryngeal nerve
- 2009
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Ingår i: The Annals of otology, rhinology, and laryngology. - : SAGE Publications. - 0003-4894 .- 1943-572X. ; 118:7, s. 506-511
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Tidskriftsartikel (refereegranskat)abstract
- Following perioperative injury to a macroscopically intact recurrent laryngeal nerve (RLN), there are two possible intraneural injury types: 1) axonal injury, including disruption of axons, and 2) conduction block, only affecting the Schwann cells and the nodes of Ranvier. In this study, it was hypothesized that the functional outcome after RLN injury may depend on the type of nerve injury. Methods: Fifteen patients with acute postoperative unilateral RLN paralysis were prospectively studied. Electrophysiological examination (laryngeal electromyography) was used to differentiate between the two types of nerve injury. Vocal fold motions were monitored by repeated laryngoscopy during the study period (up to 6 months). Three of the patients with axonal injury were treated with the regeneration-promoting agent nimodipine. Results: The patients with conduction block all recovered normal vocal fold motion, whereas patients with axonal injury within the nerve had a significantly worse outcome. The 3 patients who were treated with nimodipine all recovered normal or near-normal vocal fold mobility despite the more severe axonal injury. Conclusions: In contrast to previous reports, our results show that laryngeal electromyography is a reliable tool for diagnosing the type of injury within the injured RLN, making it possible to predict the functional outcome in these patients. On the basis of the results, a future randomized study on nimodipine treatment for RLN axonal injury is suggested.
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- Bjorck, G, et al.
(författare)
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New animal model for assessment of functional laryngeal motor innervation
- 2012
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Ingår i: The Annals of otology, rhinology, and laryngology. - : SAGE Publications. - 0003-4894 .- 1943-572X. ; 121:10, s. 695-699
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Tidskriftsartikel (refereegranskat)abstract
- The functional motor innervation of the larynx is not fully understood because of the complexity of the peripheral neuroanatomy. Since the late 19th century, there has been controversy regarding the role of the superior laryngeal nerve, which may have wider motor projections than are currently acknowledged. The aim of this study was to develop a large animal model to characterize and quantify the functional motor input to the intrinsic laryngeal muscles. Methods: We performed invasive electrophysiology (evoked electromyography) in normal pigs. Results: The thyroarytenoid, lateral cricoarytenoid, and posterior cricoarytenoid muscles receive dual innervation from both the superior and recurrent laryngeal nerves, whereas the cricothyroid muscle is innervated only by the superior laryngeal nerve. Conclusions: The dual innervation pattern from both laryngeal nerves supports the concept of a laryngeal nerve plexus. The motor input through the external branch of the superior laryngeal nerve was surprisingly high. The animal model presented here may be used in future investigations of laryngeal reinnervation following nerve injury.
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| 7. |
- Hydman, J, et al.
(författare)
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Nimodipine improves reinnervation and neuromuscular function after injury to the recurrent laryngeal nerve in the rat
- 2007
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Ingår i: The Annals of otology, rhinology, and laryngology. - : SAGE Publications. - 0003-4894 .- 1943-572X. ; 116:8, s. 623-630
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Tidskriftsartikel (refereegranskat)abstract
- Injury of the recurrent laryngeal nerve (RLN) is associated with a high degree of neuronal survival, but leads to various levels of vocal fold motion impairment or laryngeal synkinesis, which has been attributed to misdirected reinnervation of the target muscles in the larynx or aberrant, competing reinnervation from adjacent nerve fibers. The aim of the present study was to evaluate the impact of the regeneration-promoting agent nimodipine on reinnervation and neuromuscular function following RLN crush injury. Methods: Sixty adult rats were randomized into nimodipine-treated or untreated groups and then underwent RLN crush injury. Reinnervation of the posterior cricoarytenoid muscle (PCA) was assessed by electrophysiological examination, retrograde tracing of lower motor neurons before and after injury, and quantification of neuromuscular junctions in the PCA muscle. Results: At 6 weeks after injury, the nimodipine-treated animals showed significantly enhanced neuromuscular function and also demonstrated a higher number of motor neurons in the brain stem that had reinnervated the PCA, compared to the untreated animals. The somatotopic organization of ambiguus motor neurons innervating the larynx was similar before injury and after reinnervation. Conclusions: Nimodipine improves regeneration and neuromuscular function following RLN injury in the adult rat, and could be of use in future strategies following RLN injury.
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- Lind, CS, et al.
(författare)
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Quantification of Trapezius Muscle Innervation During Neck Dissections: Cervical Plexus Versus the Spinal Accessory Nerve
- 2015
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Ingår i: The Annals of otology, rhinology, and laryngology. - : SAGE Publications. - 0003-4894 .- 1943-572X. ; 124:11, s. 881-885
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Tidskriftsartikel (refereegranskat)abstract
- Despite increasing use of selective, nerve-sparing surgical techniques during neck dissections, the reported rate of postoperative paralysis of the trapezius muscle is still high. The aim of the study is to measure and compare motor inflow to the trapezius muscle, in order to better understand the peripheral neuroanatomy. Methods: Intraoperative nerve monitoring (electroneurography) in patients undergoing routine neck dissection (n = 18). The innervation of the 3 functional parts of the trapezius muscle was mapped and quantified through compound muscle action potentials. Results: In 18/18 (100%) of the patients, the spinal accessory nerve (SAN) innervated all parts of the trapezius muscle. In 7/18 (39%) of the patients, an active motor branch from the cervical plexus was detected, equally distributed to all functional parts of the trapezius muscle, at levels comparable to the SAN. Conclusions: Compared to the SAN, branches from cervical plexus provide a significant amount of neural input to all parts of the trapezius muscle. Intraoperative nerve monitoring can be used in routine neck dissections to detect these branches, which may be important following surgical injury to the SAN.
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- Ostman, C, et al.
(författare)
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Nematocyst analysis of Cyanea capillata and Cyanea lamarckii (Scyphozoa, Cnidaria)
- 1997
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Ingår i: SCIENTIA MARINA. - : INST CIENCIAS MAR BARCELONA. - 0214-8358. ; 61:3, s. 313-344
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Nematocysts of red-pigmented Cyanea capillata medusae and blue-pigmented Cyanea lamarckii medusae from the Swedish west coast were examined by light and scanning electron microscopy. In addition to homotrichous isorhizas and heterotrichous microbasic eury
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