Intrinsic Laryngeal Muscle Reinnervation Using the Muscle-Nerve-Muscle Technique

There is no current treatment method that can reliably restore physiologic movement to a paralyzed vocal fold. The purposes of this study were to test the hypotheses that 1) muscle-nerve-muscle (M-N-M) neurotization can be induced in feline laryngeal muscles and 2) M-N-M neurotization can restore movement to a paralyzed vocal fold. Muscle-nerve-muscle neurotization can be defined as the reinnervation of a denervated muscle via axons that are induced to sprout from nerves within an innervated muscle and that then traverse a nerve graft interposed between it and the target denervated muscle. a paralyzed laryngeal muscle could be reinnervated by axons from its contralateral paired muscle, thus achieving motion-specific reinnervation. Eighteen adult cats were divided into sham, hemilaryngeal-denervated, and M-N-M—reinnervated thyroarytenoid muscle groups. Five of the 6 reinnervated animals had histologic evidence of axons in the nerve graft, 4 of the 6 had evoked electromyographic evidence of crossed reinnervation, and 1 of the 6 had a return of appropriately phased adduction. This technique has great potential and should be further investigated.

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DIAPHRAGM (DPM) PLASTICITY FOLLOWING INTRINSIC LARYNGEAL MUSCLE DENERVATION (ILMX).

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-199905001-01027 ◽

1999 ◽

Vol 31 (Supplement) ◽

pp. S219

Author(s):

J. R. Rodman ◽

L. E. Gosselin ◽

P. Horvath ◽

D. Megirian ◽

G. A. Farkas

Keyword(s):

Muscle Denervation ◽

Laryngeal Muscle ◽

Intrinsic Laryngeal Muscle

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The use of targeted muscle reinnervation for improved myoelectric prosthesis control in a bilateral shoulder disarticulation amputee

Prosthetics and Orthotics International ◽

10.3109/03093640409167756 ◽

2004 ◽

Vol 28 (3) ◽

pp. 245-253 ◽

Cited By ~ 275

Author(s):

T. A. Kuiken ◽

G. A. Dumanian ◽

R. D. Lipschutz ◽

L. A. Miller ◽

K. A. Stubblefield

Keyword(s):

Degrees Of Freedom ◽

Subcutaneous Fat ◽

Pectoralis Major ◽

Myoelectric Prosthesis ◽

Targeted Muscle Reinnervation ◽

Upper Limb Prosthesis ◽

Muscle Reinnervation ◽

Major Region ◽

Prosthesis Control ◽

Nerve Muscle

A novel method for the control of a myoelectric upper limb prosthesis was achieved in a patient with bilateral amputations at the shoulder disarticulation level. Four independently controlled nerve-muscle units were created by surgically anastomosing residual brachial plexus nerves to dissected and divided aspects of the pectoralis major and minor muscles. The musculocutaneous nerve was anastomosed to the upper pectoralis major; the median nerve was transferred to the middle pectoralis major region; the radial nerve was anastomosed to the lower pectoralis major region; and the ulnar nerve was transferred to the pectoralis minor muscle which was moved out to the lateral chest wall. After five months, three nerve-muscle units were successful (the musculocutaneous, median and radial nerves) in that a contraction could be seen, felt and a surface electromyogram (EMG) could be recorded. Sensory reinnervation also occurred on the chest in an area where the subcutaneous fat was removed. The patient was fitted with a new myoelectric prosthesis using the targeted muscle reinnervation. The patient could simultaneously control two degrees-of-freedom with the experimental prosthesis, the elbow and either the terminal device or wrist. Objective testing showed a doubling of blocks moved with a box and blocks test and a 26% increase in speed with a clothes pin moving test. Subjectively the patient clearly preferred the new prosthesis. He reported that it was easier and faster to use, and felt more natural.

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Corrigendum to Effects of the Number of Muscle-Nerve-Muscle Grafts on Rat Facial Nerve Functional Recovery

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420973154 ◽

2020 ◽

pp. 000348942097315

Keyword(s):

Facial Nerve ◽

Functional Recovery ◽

Muscle Nerve ◽

Nerve Muscle

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Intrinsic Laryngeal Muscle Activity in a Spastic Dysphonia Patient

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.5001.54 ◽

1985 ◽

Vol 50 (1) ◽

pp. 54-59 ◽

Cited By ~ 34

Author(s):

Thomas Shipp ◽

Krzysztof Izdebski ◽

Charles Reed ◽

Philip Morrissey

Keyword(s):

Muscle Activity ◽

Emg Activity ◽

Muscle Paralysis ◽

Normal Morphology ◽

Laryngeal Muscles ◽

Laryngeal Muscle ◽

Intrinsic Laryngeal Muscle ◽

Posterior Cricoarytenoid ◽

Recurrent Laryngeal Nerves ◽

Intrinsic Laryngeal Muscles

EMG activity from four intrinsic laryngeal muscles (thyroarytenoid, posterior cricoarytenoid, interarytenoid, and cricothyroid) was obtained from one female spastic dysphonia patient while she performed a variety of speech and nonspeech tasks. These tasks were performed before and during a period of temporary unilateral laryngeal muscle paralysis. In the nonparalyzed condition, adductory muscle activity showed intermittent sudden increases that coincided with momentary voice arrests. These muscle patterns and accompanying voice interruptions were not present either when speech was produced in falsetto register or at anytime during the paralysis condition. The data suggest that individuals with this type of spastic dysphonia have normal morphology of recurrent laryngeal nerves and intrinsic laryngeal muscles, which means that the triggering mechanism(s) for spastic dysphonia symptoms must be located at some point neurologically upstream from the larynx.

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