Selective reinnervation of the posterior cricoarytenoid and interarytenoid muscles: An anatomical study

Abstract

This study provides new insight into laryngeal anatomy and further data for developing a reliable surgical approach.

Laryngeal reinnervation for bilateral vocal fold paralysis

“…(c) The distal transected RLN adductor branch is anastomosed to branch of ansa cervicalis for volitional adduction. Reproduced with permission from [10 ]. may also be sucked to the midline during inspiration and this would obstruct the airway.…”

“…Eller et al [11] confirm findings by Maranillo et al [17] and also that the PCA muscle receives nerves from the interarytenoid branch. Identification of PCA branches is not straightforward, as a posterior window in the thyroid cartilage was required in 57.1% of male specimens and 69.2% of female specimens in a cadaveric study [10 ].…”

“…In a technique by Kwak et al [10 ], the RLN was transected between the PCA and interarytenoid branch. If the PCA branch is secured by the thyroid cartilage, then a thyroid cartilage window is necessary.…”

“…A surgical technique close to the technique of Marie et al [8] of selective reinnervation to the PCA muscle and adductor muscles used on 20 cadavers was recently described [10 ]. The surgical technique differs from the one described by Marie et al in a few aspects.…”

“…A jump graft was used to anastomose the phrenic nerve with ipsilateral and contralateral extralaryngeal RLN (Fig. 2) [10 ]. Marie et al [8] used an interposition retrocricoid-free nerve graft to the contralateral PCA to receive phrenic nerve axons from the contralateral side.…”