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Neurotrophin expression and laryngeal muscle pathophysiology following recurrent laryngeal nerve transection

机译:喉返神经横断后神经营养蛋白的表达与喉肌病理生理学

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摘要

Laryngeal palsy often occurs as a result of recurrent laryngeal or vagal nerve injury during oncological surgery of the head and neck, affecting quality of life and increasing economic burden. Reinnervation following recurrent laryngeal nerve (RLN) injury is difficult despite development of techniques, such as neural anastomosis, nerve grafting and creation of a laryngeal muscle pedicle. In the present study, due to the limited availability of human nerve tissue for research, a rat model was used to investigate neurotrophin expression and laryngeal muscle pathophysiology in RLN injury. Twenty-five male Sprague-Dawley rats underwent right RLN transection with the excision of a 5-mm segment. Vocal fold movements, vocalization, histology and immunostaining were evaluated at different time-points (3, 6, 10 and 16 weeks). Although vocalization was restored, movement of the vocal fold failed to return to normal levels following RLN injury. The expression of brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor differed in the thyroarytenoid (TA) and posterior cricoarytenoid muscles. The number of axons did not increase to baseline levels over time. Furthermore, normal muscle function was unlikely with spontaneous reinnervation. During regeneration following RLN injury, differences in the expression levels of neurotrophic factors may have resulted in preferential reinnervation of the TA muscles. Data from the present study indicated that neurotrophic factors may be applied for restoring the function of the laryngeal nerve following recurrent injury.
机译:喉头麻痹通常是由于头颈部肿瘤外科手术中喉返神经或迷走神经的损伤而发生,影响生活质量并增加经济负担。尽管开发了诸如神经吻合术,神经移植和创建喉肌蒂等技术,但喉返神经(RLN)损伤后的神经支配仍然很困难。在本研究中,由于人类神经组织的研究有限,因此使用大鼠模型研究了RLN损伤中神经营养蛋白的表达和喉肌病理生理学。 25只Sprague-Dawley雄性大鼠经RLN横切,切除了5mm的节段。在不同的时间点(3、6、10和16周)评估了声带运动,发声,组织学和免疫染色。尽管恢复了发声,但在RLN损伤后,声带的运动未能恢复到正常水平。脑源性神经营养因子和神经胶质细胞系源性神经营养因子的表达在甲状旁腺(TA)和环缝后部类睫状肌中有所不同。随着时间的推移,轴突的数量没有增加到基线水平。此外,自发神经支配不可能正常的肌肉功能。在RLN损伤后的再生过程中,神经营养因子表达水平的差异可能导致TA肌肉优先神经支配。来自本研究的数据表明神经营养因子可用于复发性损伤后恢复喉神经的功能。

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