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Investigation of the regeneration potential of the recurrent laryngeal nerve (RLN) after compression injury, using neuromonitoring.
Moskalenko, Vasiliy; Hüller, Markus; Gasser, Martin; Demidchik, Yuriy; Thiede, Arnulf; Timm, Stephan; Ulrichs, Karin; Hamelmann, Wulf.
Afiliación
  • Moskalenko V; Department of General and Visceral Surgery, Hospital of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, D-55131, Mainz, Germany. moskalenko@tut.by
Langenbecks Arch Surg ; 394(3): 469-74, 2009 May.
Article en En | MEDLINE | ID: mdl-18751999
INTRODUCTION: The aim of this study was to investigate the regeneration potential of RLN after the compression of the nerve, without disrupting its continuity, using neuromonitoring. METHODS: In the first operation, the RLN and nervus vagus of adult Goettingen minipigs were dissected free, and the neuromonitoring parameters (amplitude, threshold and lag time of signal) were measured. Injury of the RLN was induced using a "bulldog" clamp. When the signal was no longer detectable, after the 15 min regeneration phase, the operation was finished. The neuromonitoring studies (see above) were repeated in a second operation 6 months later. RESULTS: (1) After the first operation, acute clamping of the RLN led to a reduction in the amplitude of the neuromonitoring signal; the lag time and the threshold of signal remained. Complete restitution of the signal was observed during the first regeneration phase. Repeated clamping led to complete disappearance of the signal. (2) During the second operation, i.e., after 6 months of regeneration, the neuromonitoring signals of both RLN and nervus vagus were detected in 93% of the GMP. No statistical differences (p = 0.17) were noticed between the amplitude of the RLN before the nerve injury (first operation) and after nerve regeneration (second operation). A significant increase in the lag time (p < 0.0005) was shown for both RLN and nervus vagus. CONCLUSIONS: The acute compression of RLN can only be detected by observing the amplitude of the neuromonitoring signal. Restitutio ad integrum is possible after a short clamping period but it is important to preserve the RLN continuity.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Monitoreo Intraoperatorio / Traumatismos del Nervio Laríngeo Recurrente / Síndromes de Compresión Nerviosa / Regeneración Nerviosa Límite: Animals Idioma: En Revista: Langenbecks Arch Surg Año: 2009 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Monitoreo Intraoperatorio / Traumatismos del Nervio Laríngeo Recurrente / Síndromes de Compresión Nerviosa / Regeneración Nerviosa Límite: Animals Idioma: En Revista: Langenbecks Arch Surg Año: 2009 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania