功能性神经肌肉刺激对犬神经再支配喉功能恢复的作用

Effect of functional neuromuscular stimulation on the recovery of larynx function after regeneration of recurrent laryngeal nerve in canine

目的:在功能性神经肌肉刺激应用时间不同的情况下,观察实验动物模型喉功能的恢复情况。方法:实验于2002-02/2003-03在郑州大学耳鼻咽喉研究所进行,选用成年杂种犬6只,喉返神经切断后通过直接缝合法吻合神经,分别给于喉返神经和环杓后肌不同时程的功能性神经肌肉刺激处理,通过采集肌电图和声门图像,并予及喉返神经Mallory神经组织染色,观察声门活动恢复情况和神经再生情况。结果:实验动物6只均进入结果分析。①肌电图提示进行神经肌肉刺激处理的动物,双侧环杓后肌的电活动基本上是同步的,声门活动恢复,没有出现喉的联带运动。②进行喉返神经肌肉刺激处理的动物,再生数量(≥759)明显多于未进行处理的动物(580),而且随神经肌肉刺激应用时间的延长而增多。结论:将神经肌肉刺激间断性应用于喉返神经,持续性应用于环杓后肌可以获得最佳的声门恢复效果。

AIM：To observe the restoration of larynx function under different functional neuromuscular stimulation （FNS） treatment duration. METHODS：The experiment was undertaken between February 2002 and March 2003 in the Institute of Otorhinolaryngology of Zhengzhou University. Six healthy adult mongrel canines were subjected to recurrent laryngeal nerve （RLN） injury and treated with functional neuromuscular stimulation of different modes and duration, Electromyographic recording of posterior cricoarytenoid muscle, imaging of glottis movements and Mallory＇s trichrome staining of recurrent laryngeal nerve were used to observe the glottis movement restoration and nerve regeneration. RESULTS： All the 6 experimental animals were involved in the analysis of results, ① electromyographic recording showed that the functional neuromuscular stimulation treated animals had synchronous bilateral electro-movement of posterior cricoarytenoid muscle.Their glottis movement restored and had no laryngeal synkinesis.② The quantity of regenerated fiber in the animals treated with functional neuromuscular stimulation of recurrent laryngeal nerve （≥ 759） was obviously more than in the untreated ones （580）,and the quantity grew with the treated duration of functional neuromuscular stimulation. CONCLUSiON：Intermittent functional neuromuscular stimulation treatment of recurrent laryngeal nerve,combined with continuous functional neuromuscular stimulation treatment of posterior crieoarytenoid muscle can restore glottis function to the utmost.