Intrinsic laryngeal muscle reinnervation with nerve-muscle pedicle

Abstract

OBJECTIVE: To test the application of the nerve-muscle pedicle (NMP) technique for selective rein-nervation of previously denervated posterior cricoarytenoid (PCA) muscle. METHODS: The left recurrent laryngeal nerve (RLN) was severed in 5 mongrel dogs, and an ansa cervicalis-sternohyoid muscle pedicle was sutured to the left PCA muscle. Three dogs underwent a sham operation. Videolaryngoscopy was performed, and electromyographic data were collected after 1 year on average. Finally, histologic analysis of the NMP was performed. RESULTS: The video records showed the return of mobility of the PCA muscle reinnervated by the NMP. EMG data as to show evoked polyphasic potentials showed also evidence of reinnervation of the PCA muscle. With immunohistochemical reaction (antineurofilament antibody+biotin) we could show neurofilaments and motor endplates in both sides in all 5 animals. CONCLUSIONS: The NMP technique could eliminate the need for arytenoidectomy and laterofixation in patients with unilateral or bilateral vocal fold paralysis. The quality of life and voice may be improved. (Otolaryngol Head Neck Surg 2005;132:701-6.)