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Functional identification of abductor and adductor branches for laryngeal transplantation

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Abstract

Purpose

This is a feasibility study of functional identification of the abductor and adductor recurrent laryngeal nerve branches, which could be used in the donor’s larynx for functional laryngeal transplantation.

Methods

The study was performed on swine (n = 3) and human (n = 4) models of a donor larynx. The recurrent laryngeal nerve and its branches were found. Using stimulator, abductor and adductor branches were identified, and glottis closing and opening were captured with an endoscope.

Results

The result was positive if two ENT specialists noticed at least one adduction and one abduction movement in the same subject. It was obtained in three out of three swine and three out of four humans.

Conclusions

This study shows a way of reinnervation of a transplanted larynx which might result in a functional organ. It describes the first step of the procedure: functional identification of the abductor and adductor branches of the recurrent laryngeal nerve in the donor before the larynx is excised for transplantation.

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Author information

Correspondence to Wojciech Kukwa.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Video 1. Adductive movement of left vocal fold in human (MP4 5254 KB)

Video 1. Adductive movement of left vocal fold in human (MP4 5254 KB)

Video 2. Abductive movement of left vocal fold in human (MP4 7228 KB)

Video 2. Abductive movement of left vocal fold in human (MP4 7228 KB)

Video 3. Adductive movement of right vocal fold (upper part of picture) in swine (MP4 6586 KB)

Video 3. Adductive movement of right vocal fold (upper part of picture) in swine (MP4 6586 KB)

Video 4. Abductive movement of right vocal fold (upper part of picture) in swine (MP4 4978 KB)

Video 4. Abductive movement of right vocal fold (upper part of picture) in swine (MP4 4978 KB)

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Cite this article

Migacz, E., Howard, D., Gajewski, Z. et al. Functional identification of abductor and adductor branches for laryngeal transplantation. Eur Arch Otorhinolaryngol 275, 2813–2816 (2018) doi:10.1007/s00405-018-5112-3

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Keywords

  • Larynx
  • Microvascular reconstruction and transplant surgery
  • Airway stenosis/reconstruction
  • Laryngeal reinnervation