scholarly journals Nerve Stimulator-guided Injection of Autologous Stem Cells Near the Equine Left Recurrent Laryngeal Nerve

10.3791/58023 ◽  
2018 ◽  
Author(s):  
Charlotte Sandersen ◽  
Justine Ceusters ◽  
Alexia Fourez ◽  
Irene Tosi ◽  
Helene Graide ◽  
...  
Keyword(s):  
Stem Cells ◽  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Nerve Stimulator ◽  
Left Recurrent Laryngeal Nerve

scholarly journals Regeneration of Transected Recurrent Laryngeal Nerve Using Hybrid-Transplantation of Skeletal Muscle-Derived Stem Cells and Bioabsorbable Scaffold

2018 ◽  
Vol 7 (9) ◽  
pp. 276 ◽  
Author(s):  
Akihito Kazuno ◽  
Daisuke Maki ◽  
Ippei Yamato ◽  
Nobuyuki Nakajima ◽  
Hiroya Seta ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Stem Cells ◽  
Recurrent Laryngeal Nerve ◽  
Green Fluorescence Protein ◽  
Immunohistochemical Analysis ◽  
Laryngeal Nerve ◽  
Multipotent Stem Cells ◽  
Enhanced Expression ◽  
Endoneurial Cells ◽  
Pga Felt

Hybrid transplantation of skeletal muscle-derived multipotent stem cells (Sk-MSCs) and bioabsorbable polyglyconate (PGA) felt was studied as a novel regeneration therapy for the transected recurrent laryngeal nerve (RLN). Sk-MSCs were isolated from green fluorescence protein transgenic mice and then expanded and transplanted with PGA felt for the hybrid transplantation (HY group) into the RLN transected mouse model. Transplantation of culture medium (M group) and PGA + medium (PGA group) were examined as controls. After eight weeks, trans-oral video laryngoscopy demonstrated 80% recovery of spontaneous vocal-fold movement during breathing in the HY group, whereas the M and PGA groups showed wholly no recoveries. The Sk-MSCs showed active engraftment confined to the damaged RLN portion, representing favorable prevention of cell diffusion on PGA, with an enhanced expression of nerve growth factor mRNAs. Axonal re-connection in the HY group was confirmed by histological serial sections. Immunohistochemical analysis revealed the differentiation of Sk-MSCs into Schwann cells and perineurial/endoneurial cells and axonal growth supportive of perineurium/endoneurium. The number of axons recovered was over 86%. These results showed that the stem cell and cytokine delivery system using hybrid transplantation of Sk-MSCs/PGA-felt is a potentially practical and useful approach for the recovery of transected RLN.

scholarly journals Extra-laryngeal branching of recurrent laryngeal nerve: a possibility thyroid surgeons need to keep in mind to prevent inadvertent nerve injury

2019 ◽  
Vol 12 (11) ◽  
pp. e231305
Author(s):  
Gokul Gopi ◽  
Saurav Sarkar ◽  
Anindya Nayak
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Preoperative Assessment ◽  
Central Compartment ◽  
Needle Aspiration ◽  
Laryngeal Nerve ◽  
Aspiration Cytology ◽  
Left Recurrent Laryngeal Nerve ◽  
Needle Aspiration Cytology

A 45-year-old woman presented with a neck swelling since the past 6 years. The swelling was painless but slowly and progressively increasing in size. On examination, a thyroid swelling of size approximately 6×4 cm was seen on the left side. Ultrasonography revealed the size to be 6×5 cm with microcalcifications. Fine needle aspiration cytology revealed the mass to be papillary carcinoma. She was planned for total thyroidectomy with central compartment clearance. Preoperative assessment including thyroid hormone profile was normal and the patient was taken for surgery after proper anaesthesia clearance. During the surgery, it was found that there was a branching of the left recurrent laryngeal nerve. The branching was confirmed with nerve monitor and careful dissection was done to prevent injuries. The surgery was completed successfully without any nerve damage and the postoperative period was uneventful. Follow-up assessments revealed no signs of nerve injury like hoarseness of voice. Possibility of abnormal branches and duplication of nerves though uncommon should not be underestimated and extra vigilance and caution must be exercised when operating near a nerve, even by an experienced surgeon familiar with the local anatomy. Any doubts arising during the surgery must be clarified immediately, and nerve monitors should be used to check suspected branching and duplications before proceeding further.

VS01.04: RELIABLE SURGICAL TECHNIQUES FOR LYMPHADENECTOMY ALONG THE LEFT RECURRENT LARYNGEAL NERVE DURING THORACOSCOPIC ESOPHAGECTOMY IN THE PRONE POSITION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 44-44
Author(s):  
Taro Oshikiri ◽  
Tetsu Nakamura ◽  
Hiroshi Hasegawa ◽  
Masashi Yamamoto ◽  
Shingo Kanaji ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Recurrent Laryngeal Nerve ◽  
Prone Position ◽  
Conflicts Of Interest ◽  
Surgical Techniques ◽  
Laryngeal Nerve ◽  
Thoracoscopic Esophagectomy ◽  
Left Recurrent Laryngeal Nerve

Abstract Description Background Lymphadenectomy along the left recurrent laryngeal nerve (RLN) in esophageal cancer is important for disease control but requires advanced dissection skills. Complete dissection of the lymph nodes along the left RLN in a safe manner is important. We demonstrate the reliable method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the prone position (TEP). Methods This procedure is performed for all of resectable thoracic esophageal cancers. The essence of this method is to recognize the lateral pedicle as a two-dimensional membrane that inclu replicatedes the left RLN, lymph nodes around the nerve, and primary esophageal arteries. By drawing the proximal portion of the divided esophagus and the lateral pedicle, identification and reliable cutting of the primary esophageal arteries and distinguishing the left RLN from the lymph nodes are simplified. Results We performed 46 TEPs for esophageal cancer using this method with no conversion to an open procedure in 2015 at Kobe University. No intraoperative morbidity related to the left RLN was observed. The mean number of harvested lymph nodes along the left RLN was 6.9 ± 4.2. Left RLN palsy greater than Clavien-Dindo classification grade II occurred in 4 patients (8%), all of them were reversible. The incidence of lymph node metastasis along the left RLN was 22%. Conclusion Our method for lymphadenectomy along the left RLN during TEP is safe and reliable. It has a low incidence of left RLN palsy and provides sufficient lymph node dissection along the left RLN. Disclosure All authors have declared no conflicts of interest.

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