Functioning Remobilization of the Paralyzed Vocal Cord in Dogs

Abstract

Anastomoses of the split vagus nerve to the adductor division of the recurrent nerve intralaryngeally and, simultaneously, the phrenic nerve to the abductor division of the recurrent nerve extralaryngeally were carried out with meticulous technique under the operating microscope. Each suture line was protected by silicone elastomer tubing. The rationale behind these simultaneous separate nerve anastomoses was to attempt to avert crossed reinnervation and dyssynergia that often results from other nerve anastomosis techniques. Results were evaluated by follow-up of the animals with electromyographic studies and 16-mm motion pictures. All experimental animals regained normal and symmetrical electromyographic function, a high degree of voluntary synchronous adduction, and to a somewhat lesser extent, spontaneous synchronous abduction, at 12 to 14 months postoperatively. Results indicate that simultaneous separate nerve anastomosis offers promise for active reinnervation of the paralyzed larynx.