Phrenic-Recurrent Nerve Anastomosis in Animal Models with Unilateral Cutting of the Recurrent Nerve

Abstract

In our experimental study, the aim was to recover vocal cord physiology in cutting of recurrent laryngeal nerve, thus phrenic-recurrent nerve transposition was planned in rabbits. Experiments were performed on 10 experimental and 10 control rabbits. The right recurrent nerve was cut in the control group, while in the experiment group, the right recurrent nerve was cut. Then, a right phrenic-recurrent nerve end-to-end anastomosis was performed and the results were evaluated. After the 3rd postoperative week, videolaryngoscopy (VLS) and intramuscular electromyography (EMG) could not be evaluated in 1 rabbit from the experimental group which had died during anesthesia. In eight of the nine rabbits in the experiment which underwent VLS and EMG, activity was recorded in the right vocal cords. On light microscopic examination, atrophy was not detected in the vocal cord muscles of 9 rabbits among the 10 in the experiment group, while all rabbits in the control group and 1 rabbit in the experiment group were diagnosed with vocal cord atrophy. A success rate of approximately 90% was obtained based on the pathologic examination. We believe that the method can be used in patients without any contraindications, considering the complications of tracheostomy and the quality of life.

Interrecurrent nerve anastomosis with free nerve graft transposition in rabbits

“…The surgeon should be alerted for possible iatrogenic injury to the recurrent nerve if there is no lumen identified in one of these transected structures. In the previous animal study by Engin et al (21) an end-to-end anastomosis was performed between the phrenic and recurrent laryngeal nerves, and the vocal cord function was demonstrated with videolaryngoendoscopy and laryngeal EMG, with an up to 90% success rate. Despite these results, this operation is not recommended in elderly patients particularly in those with compromised respiratory function.…”