scholarly journals TrkA inhibitor promotes motor functional regeneration of recurrent laryngeal nerve by suppression of sensory nerve regeneration

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hiroshi Suzuki ◽  
Koji Araki ◽  
Toshiyasu Matsui ◽  
Yuya Tanaka ◽  
Kosuke Uno ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Regeneration ◽  
Vocal Fold ◽  
Compound Muscle Action Potential ◽  
Motor Nerve ◽  
Sensory Nerve ◽  
Laryngeal Nerve ◽  
Sensory Nerves ◽  
Nucleus Ambiguus ◽  
Functional Regeneration

Abstract Recurrent laryngeal nerve (RLN) injury, in which hoarseness and dysphagia arise as a result of impaired vocal fold movement, is a serious complication. Misdirected regeneration is an issue for functional regeneration. In this study, we demonstrated the effect of TrkA inhibitors, which blocks the NGF-TrkA pathway that acts on the sensory/automatic nerves thus preventing misdirected regeneration among motor and sensory nerves, and thereby promoting the regeneration of motor neurons to achieve functional recovery. RLN axotomy rat models were used in this study, in which cut ends of the nerve were bridged with polyglycolic acid-collagen tube with and without TrkA inhibitor (TrkAi) infiltration. Our study revealed significant improvement in motor nerve fiber regeneration and function, in assessment of vocal fold movement, myelinated nerve regeneration, compound muscle action potential, and prevention of laryngeal muscle atrophy. Retrograde labeling demonstrated fewer labeled neurons in the vagus ganglion, which confirmed reduced misdirected regeneration among motor and sensory fibers, and a change in distribution of the labeled neurons in the nucleus ambiguus. Our study demonstrated that TrkAi have a strong potential for clinical application in the treatment of RLN injury.

Recurrent Laryngeal Nerve Regeneration by Tissue Engineering

2003 ◽  
Vol 112 (6) ◽  
pp. 492-498 ◽  
Author(s):  
Shin-Ichi Kanemaru ◽  
Koichi Omori ◽  
Yasuyuki Hiratsuka ◽  
Hisayoshi Kojima ◽  
Juichi Ito ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Compound Muscle Action Potential ◽  
Polyglycolic Acid ◽  
Nerve Graft ◽  
Laryngeal Nerve ◽  
Nerve Conduit ◽  
Surgical Methods ◽  
Functional Regeneration ◽  
Group 2 ◽  
Group 1

The recurrent laryngeal nerve (RLN) does not regenerate well after it has been cut, and no current surgical methods achieve functional regeneration. Here, we evaluate the functional regeneration of the RLN after reconstruction using a biodegradable nerve conduit or an autologous nerve graft. The nerve conduit was made of a polyglycolic acid (PGA) tube coated with collagen. A 10-mm gap in the resected nerve was bridged by a PGA tube in 6 adult beagle dogs (group 1) and by an autologous nerve graft in 3 dogs (group 2). Fiberscopic observation revealed functional regeneration of the RLN in 4 of the 6 dogs in group 1. No regeneration of the RLN was observed in any dog in group 2. We also tested for axonal transport, and measured the compound muscle action potential. The RLN can be functionally regenerated with a PGA tube, which may act as a scaffold for the growth of regenerating axons.

Partial Thyroarytenoid Myectomy: An Animal Study Investigating a Proposed New Treatment for Adductor Spasmodic Dysphonia

1993 ◽  
Vol 108 (3) ◽  
pp. 256-264 ◽  
Author(s):  
Sheldon H. Genack ◽  
Peak Woo ◽  
Raymond H. Colton ◽  
Donna Goyette
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Stimulation ◽  
Vocal Fold ◽  
Compound Muscle Action Potential ◽  
Contralateral Side ◽  
Laryngeal Nerve ◽  
Spasmodic Dysphonia ◽  
True Vocal Cord ◽  
Laryngeal Function ◽  
Adductor Spasmodic Dysphonia

A new surgical procedure with potential application for the treatment of adductor spasmodic dysphonia was performed on ten rabbits to assess surgical effects on laryngeal function. Using an external approach, partial unilateral thyroarytenoid (TA) muscle excision was performed through a thyroplasty cartilage window. The contralateral side was left undisturbed as a control. The animals were studied acutely and at 3 months using videolaryngoscopy. Electrophysiologic measurements were recorded at 3 months. The procedure was well tolerated by all animals, with no postoperative infection or aspiration. At 3 months, spontaneous and evoked (recurrent laryngeal nerve stimulation) TA muscle electromyographic potentials were measurable bilaterally. TA compound muscle action potential amplitudes were reduced on the side of myectomy. The threshold of recurrent laryngeal nerve stimulation needed to produce observable vocal fold adduction was increased on the side operated on. Perioperative and long-term (3 months) videolaryngoscopy demonstrated preservation of laryngeal competence with good true vocal cord adduction. Histologic analysis with whole organ sections showed replacement of excised muscle with loose fibroareolar tissue. No evidence of muscle regeneration was observed. The vocal ligament and vocal fold mucosa were intact and undistorted in all specimens. This procedure is technically simple and appears to effectively result in a functional yet weakened TA muscle. Because myectomy includes motor unit end-plate excision, problems associated with reinnervation may be circumvented. TA myectomy may be applicable in patients with focal laryngeal dystonia to decrease muscle spasm.

Fiber Components of the Recurrent Laryngeal Nerve in the Cat

1976 ◽  
Vol 85 (4) ◽  
pp. 460-471 ◽  
Author(s):  
Richard R. Gacek ◽  
Michael J. Lyon
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Motor Nerve ◽  
Cranial Nerves ◽  
Superior Laryngeal Nerve ◽  
Muscle Spindles ◽  
Nerve Fibers ◽  
Laryngeal Nerve ◽  
Nucleus Ambiguus ◽  
Fiber Components ◽  
Sensory Fibers

Experimental neuroanatomical methods were employed in 21 adult cats to determine 1) the number and size of myelinated motor and sensory fibers in the recurrent laryngeal nerve (RLN), and 2) the fiber components originating in the nucleus ambiguus (NA) and retrofacial nucleus (RFN) of the brain stem. Intracranial transection of the X and XI cranial nerves and selective destruction of the NA or RFN were the experimental lesions inflicted in order to obtain the following results. About 55% (312) of the right RLN (565 fibers) is composed of myelinated motor nerve fibers which measure 4 μ − 9 μ in diameter. Nine percent come from the RFN and are smaller (4–6 μ) than the 46% which emanate from the NA and measure 6–9 μ in diameter. The remaining 45% of the RLN is made up of sensory neurons which can be divided into three groups. 1)The largest numerical group (32%) is very small in caliber (1–3 μ) and supplies extralaryngeal regions (trachea, esophagus). 2) The intermediate size fiber group (4–9 μ) comprises 11% of the RLN and probably supplies the subglottic mucosa. 3) The smallest group (2%) of sensory fibers is the largest in diameter (10–15 μ) and may represent either the innervation of muscle spindles or afferents from the superior laryngeal nerve coursing down into the chest.

Recurrent Laryngeal Nerve Regeneration through a Silicone Tube Produces Reinnervation without Vocal Fold Mobility in Rats

2013 ◽  
Vol 122 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Yoshihiko Kumai ◽  
Takashi Aoyama ◽  
Kohei Nishimoto ◽  
Tetsuji Sanuki ◽  
Ryosei Minoda ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Regeneration ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
Silicone Tube

Correlation between Stroboscopy and Electromyography in Laryngeal Paralysis

1993 ◽  
Vol 102 (11) ◽  
pp. 852-857 ◽  
Author(s):  
John Kokesh ◽  
Lawrence R. Robinson ◽  
Paul W. Flint ◽  
Charles W. Cummings
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Therapeutic Intervention ◽  
Vocal Fold ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Previous Surgery ◽  
Laryngeal Paralysis ◽  
The Status ◽  
Laryngeal Nerve Injury ◽  
Vocal Fold Motion

Twenty patients with vocal fold motion impairment were reviewed to correlate the findings of electromyography (EMG) and stroboscopy. The causes of motion impairment were idiopathic, previous surgery with recurrent laryngeal nerve injury, neck and skull base trauma, and neoplasm. The EMG studies were analyzed to assess the status of innervation of the immobile vocal fold. The presence or absence of the mucosal wave prior to therapeutic intervention was determined with stroboscopic examination. Eight of 10 patients with EMG evidence of reinnervation or partial denervation were found to have mucosal waves, and 3 of 10 patients with EMG evidence of denervation were found to have mucosal waves. Six patients developed mucosal waves after surgical medialization, despite evidence of denervation by EMG criteria. These findings support the premise that tension and subglottic pressure, rather than status of innervation, determine the presence of the mucosal wave.

Very Early Neurophysiological Study in Guillain-Barre Syndrome

2018 ◽  
Vol 80 (1-2) ◽  
pp. 100-105 ◽  
Author(s):  
Jiaoting Jin ◽  
Fangfang Hu ◽  
Xing Qin ◽  
Xuan Liu ◽  
Min Li ◽  
...  
Keyword(s):  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Tibial Nerve ◽  
Early Stage ◽  
Motor Nerve ◽  
Sensory Nerve ◽  
Sensory Nerves ◽  
Motor Nerve Conduction ◽  
Abnormal Rate ◽  
Motor Nerves

Purpose: The diagnosis of Guillain-Barre syndrome (GBS) in the very early stage may be challenging. Our aim was to report the neurophysiological abnormalities in GBS within 4 days of clinical onset. We expected that GBS will be diagnosed by the assistance of neurophysiological study in the very early stage. Methods: We prospectively recruited patients with a diagnosis of GBS discharged from First Affiliated Hospital of Xi’an Jiaotong University and Xi Jing Hospital. Patients were classified into 3 groups according to the onset of symptoms to electromyography examination interval (OEI). The neurophysiological findings were carried out using standard procedures. All patients were examined by the same experienced neurophysiologist. Results: There were not significant group differences in abnormal rate, distal motor latency (DML), motor nerve conduction velocity (MNCV), F response (FR), compound muscle action potential (CMAP), conduction block (CB), sensory nerve action potential (SNAP), and sensory nerve conduction velocity among OEI ≤4 days, 4< OEI ≤10 days, and OEI > 10 days groups. Motor nerves were more affected than sensory nerves in neurophysiological presentation in very early stage patients. The difference of motor nerves and sensory nerves was statistically significant in lower limbs, but was not in upper limbs. In motor nerve conduction studies, the abnormal rate of DML, MNCV, FR, CB was more common seen in ulnar and peroneal nerve than median and tibial nerve, the abnormal rate of CMAP was the same in ulnar, median, peroneal and tibial nerve. In sensory nerve conduction studies, the abnormal rate of ulnar nerve and median nerve was higher than the superficial peroneal nerve and sural nerve. The OEI was not correlated with the SNAP decrease rate of median (r = 0.10, p = 0.23) and ulnar (r = 0.26, p = 0.06) but was statistically correlated with sural SNAP decrease rate (r = 0.29, p = 0.04). The sural-sparing pattern phenomenon was the most commonly discovered phenomenon in very early stage patients (OEI ≤4 days), followed by patients with 4< OEI ≤10 days, ultimately found in patients with OEI > 10 days. Conclusions: We suggest performing neurophysiological examination as soon as possible for suspected GBS patients, particularly focusing on multi-spots inspection of ulnar and peroneal nerves, and paying close attention to sural-sparing patterns.

Somatotopic Changes in the Nucleus Ambiguus After Section and Regeneration of the Recurrent Laryngeal Nerve of the Rat

2014 ◽  
Vol 297 (5) ◽  
pp. 955-963 ◽  
Author(s):  
Ignacio Hernández-Morato ◽  
Gabriel Berdugo-Vega ◽  
Jose R. Sañudo ◽  
Stephen Mchanwell ◽  
Teresa Vázquez ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Nucleus Ambiguus

scholarly journals Normal neurophysiologic parameters of the median nerve among adult healthy Sudanese population

2020 ◽  
Vol 10 (4) ◽  
pp. 136-141
Author(s):  
Mohammed Salah Elmagzoub ◽  
Ahmed Hassan Ahmed ◽  
Hussam M A Hameed
Keyword(s):  
Action Potential ◽  
Median Nerve ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Compound Muscle Action Potential ◽  
Motor Nerve ◽  
Sensory Nerve ◽  
Peak Latency ◽  
Muscle Action Potential ◽  
Sensory Nerve Action

Background: Nerve conduction studies (NCSs) help in delineating the extent distribution of neural lesion, and the diagnosis of peripheral nerve disorders. Because normative nerve conduction parameters were not yet established in Sudan EMG laboratories, this study aims towards having our own reference values, as we are using the American and British parameters. This will allow avoiding the discrepancies that might be induced by many factors. Methods: NCSs were performed in 200 Median nerves of 100 adult healthy Sudanese subjects using standardized techniques. Results: The median SNAP (sensory nerve action potential) values were as follows: distal latency, 2.6±3 ms with a range of (2.3-2.9); peak latency, 3.5±0.5 ms (3.0-4.0); amplitude, 47.7±18.0μV (29.7-65.7); conduction velocity, 53.0±7.8 m/s (45.2-60.8). The following values were obtained for the Median nerve CMAP (compound muscle action potential) at wrist stimulation: distal latency, 3.5±0.5 ms with a range of (3.0-4.0); peak latency, 9.4± 1.0 ms (8.4-10.4); duration, 5.9±0.9 ms (5.0-6.8); amplitude, 12.3±2.5 mV (9.8-14.8); area, 43.0±10.4 mVms (32.6-53.4); conduction velocity, 63.6±6.2 m/s (57.4-69.8). The F wave was 28.4±1.8 ms (26.6-30.2). Conclusion: The overall mean sensory and motor nerve conduction parameters for the tested nerve compared favorably with the existing literature with some discrepancies that were justified.

Sign in / Sign up

Export Citation Format

Share Document