The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
José Ramón Sañudo - One of the best experts on this subject based on the ideXlab platform.
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Proposal of landmarks for clamping neurovascular elements during endoscopic surgery of the supraglottic region
Head & neck, 2012Co-Authors: R. Souviron, Eva Maranillo, Teresa Vázquez, N. Patel, Stephen Mchanwell, I. Cobeta, Bartolome Scola, José Ramón SañudoAbstract:Background Bleeding within the supraglottic region can be a lethal complication after CO2 laser microsurgery. Our aim was to propose endoluminal anatomical landmarks to locate the superior Laryngeal vessels resulting in a safer microsurgery. Methods Endoluminal dissections were made in 22 larynges without Laryngeal disease. Results The neurovascular structures were in the superior third of a triangle defined by the vocal process, the anterior commissure, and the epiglottic attachment of the aryepiglottic fold. They overlapped in 4 different ways: pattern I (70.4%): superior Laryngeal vein (SLV), superior Laryngeal artery (SLA), and Internal Laryngeal Nerve (ILN); pattern II (13.6%): SLA, SLV, ILN; pattern III (4.6%): SLV, ILN, and SLA; pattern IV (4.6%): SLA, ILN, and SLV. Conclusion Microsurgery in the supraglottic region may be safer if surgeons are aware of the superior third of the above-defined triangle, “danger area”, where the vascular elements of this region are located. © 2012 Wiley Periodicals, Inc. Head Neck, 2013
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variability in Nerve patterns of the adductor muscle group supplied by the recurrent Laryngeal Nerve
Laryngoscope, 2005Co-Authors: Eva Maranillo, Cesar Orus, Miquel Quer, Xavier León, José Ramón SañudoAbstract:Introduction: Accurate knowledge of the Nerve supply of each individual muscle is needed to achieve a successful selective reinnervation of the larynx. The aim of the present work was to study the Nerve supply of the adductor Laryngeal muscles supplied by the recurrent Laryngeal Nerve. Study Design: Morphologic study of human larynges. Methods: The muscular Nerve supply was studied in a total sample of 75 human larynges obtained from necropsies (47 males and 28 females, age range from 41–95 years) and examined by careful dissection using a surgical microscope. Results: The arytenoid muscle received one branch from each recurrent Nerve. In 88% of cases, this branch arose in a common trunk with the upper branch of the posterior cricoarytenoid muscle. In 8% of cases, the Nerve for the arytenoid muscle also had a branch going to the lateral cricoarytenoid muscle. The arytenoid muscle also received from one to three pairs of branches from the posterior division of the Internal Laryngeal Nerve; these were interconnected ipsi- and contralaterally and were also connected to the two branches coming from the recurrent Laryngeal Nerve. The lateral cricoarytenoid muscle received from one to six branches from the recurrent Nerve, but in 5.8% of cases, it also received a twig from a connecting branch between the recurrent Nerve and the external (5.6%) or the Internal Laryngeal Nerves (0.2%). The thyroarytenoid muscle received from one to four branches from the recurrent Nerve, but in 5.6% of cases, it also received a twig from a connecting branch between the recurrent Nerve with the external (4.6%) or the Internal (1%) Laryngeal Nerves. Conclusion: No abductor or adductor division of the recurrent Laryngeal Nerve was found in the present study. In 88% of cases, the Nerve supply to the arytenoid muscle (adductor) and the posterior cricoarytenoid muscle (abductor) arose from a common trunk, which in 8% of cases, also had a branch to the lateral cricoarytenoid muscle. Furthermore, the high incidence of branches innervating the adductor muscles from connections between the recurrent Laryngeal Nerve and the Internal and external Laryngeal Nerves led us to reconsider the contribution of these Nerves in the supply to this muscle group.
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An anatomical study of anastomoses between the Laryngeal Nerves.
The Laryngoscope, 1999Co-Authors: José Ramón Sañudo, Eva Maranillo, Cesar Orus, Xavier León, Rosa‐maría Mirapeix, Miquel QuerAbstract:Objective: To systematize the anatomy of the connecting branches between Laryngeal Nerves. Methods: Microdissection of 90 larynges obtained from necropsies (57 men and 33 women; age range, 41–95 y). Results: Anastomoses between the Internal and recurrent Nerves appeared in four different patterns: 1) Galen's anastomosis, as the connection between the dorsal branches of both Nerves (100%); 2) arytenoid plexus, as the connection between the arytenoid branches of both Nerves, in relation with the arytenoid muscle, and divided in a deep part (100%) and a superficial part (86%); 3) cricoid anastomosis, previously only described in cows, located in the front of the cricoid lamina (6/10 cases); and 4) thyroarytenoid anastomosis, as the connection of a descending branch of the Internal Laryngeal Nerve and an ascending branch of the recurrent Nerve (14%). Anastomosis between the Internal Laryngeal and the external Laryngeal Nerves appeared as a connecting branch throughout the foramen thyroideum (21%). Anastomosis between the external Laryngeal and recurrent Nerves appeared as a connecting branch throughout the cricothyroid muscle (68%). Conclusion: At least two anastomoses (Galen's anastomosis and arytenoid plexus) appeared in 21% of hemilarynges, and 79% of cases had three or more anastomoses between the Laryngeal Nerves. The different prevalence of this complex anastomotic pattern suggests functional differences in the sensory and motor innervation of individual subjects. Key Words: Larynx, innervation, anastomosis, Nerves.
Gerald N. Mccall - One of the best experts on this subject based on the ideXlab platform.
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Thermomechanical facilitation of swallowing evoked by electrical Nerve stimulation in cats
Dysphagia, 1994Co-Authors: Gloria Chi-fishman, Norman F. Capra, Gerald N. MccallAbstract:Application of a cold metal probe to the anterior faucial pillar has been reported to improve swallowing in some patients with dysphagia. Although a variety of stimuli contribute to the initiation of swallowing, the effects of a controlled, cold-thermal stimulus combined with mechanical stimulation have not been examined. It is known that simultaneous stimulation of the glossopharyngeal Nerve (IX) and the superior Laryngeal Nerve may summate to facilitate swallowing in the cat. The goal of this study was to determine whether thermomechanical stimulation of the mucosa innervated by IX would interact with threshold electrical stimulation of the Internal Laryngeal Nerve (ILN) to augment the swallowing response in cats. Four experimental conditions were tested over 24 trials in 4 pentobarbital-anesthetized cats. These included electrical stimulation of ILN, mechanical stimulation of the anterior faucial pillar with a thermode at ambient (room) temperature, concurrent ambient-mechanical and electrical stimulation, and concurrent cold-mechanical and electrical stimulation. Tissue was cooled to 8.9°C during cold-mechanical-electrical stimulation and 25.3°C during ambient-mechanical-electrical and ambient-mechanical alone stimulation. Ambient-mechanical stimulation alone did not produce swallowing. However, both forms of thermomechanical-electrical stimulation elicited a significantly greater number of swallows than did electrical stimulation alone. Therefore, mechanical stimulation with a thermode was capable of modifying the swallowing response in neurologically intact cats. Differences between stimulation with a probe at ambient and at cold temperatures were not significant.
Eva Maranillo - One of the best experts on this subject based on the ideXlab platform.
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Proposal of landmarks for clamping neurovascular elements during endoscopic surgery of the supraglottic region
Head & neck, 2012Co-Authors: R. Souviron, Eva Maranillo, Teresa Vázquez, N. Patel, Stephen Mchanwell, I. Cobeta, Bartolome Scola, José Ramón SañudoAbstract:Background Bleeding within the supraglottic region can be a lethal complication after CO2 laser microsurgery. Our aim was to propose endoluminal anatomical landmarks to locate the superior Laryngeal vessels resulting in a safer microsurgery. Methods Endoluminal dissections were made in 22 larynges without Laryngeal disease. Results The neurovascular structures were in the superior third of a triangle defined by the vocal process, the anterior commissure, and the epiglottic attachment of the aryepiglottic fold. They overlapped in 4 different ways: pattern I (70.4%): superior Laryngeal vein (SLV), superior Laryngeal artery (SLA), and Internal Laryngeal Nerve (ILN); pattern II (13.6%): SLA, SLV, ILN; pattern III (4.6%): SLV, ILN, and SLA; pattern IV (4.6%): SLA, ILN, and SLV. Conclusion Microsurgery in the supraglottic region may be safer if surgeons are aware of the superior third of the above-defined triangle, “danger area”, where the vascular elements of this region are located. © 2012 Wiley Periodicals, Inc. Head Neck, 2013
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variability in Nerve patterns of the adductor muscle group supplied by the recurrent Laryngeal Nerve
Laryngoscope, 2005Co-Authors: Eva Maranillo, Cesar Orus, Miquel Quer, Xavier León, José Ramón SañudoAbstract:Introduction: Accurate knowledge of the Nerve supply of each individual muscle is needed to achieve a successful selective reinnervation of the larynx. The aim of the present work was to study the Nerve supply of the adductor Laryngeal muscles supplied by the recurrent Laryngeal Nerve. Study Design: Morphologic study of human larynges. Methods: The muscular Nerve supply was studied in a total sample of 75 human larynges obtained from necropsies (47 males and 28 females, age range from 41–95 years) and examined by careful dissection using a surgical microscope. Results: The arytenoid muscle received one branch from each recurrent Nerve. In 88% of cases, this branch arose in a common trunk with the upper branch of the posterior cricoarytenoid muscle. In 8% of cases, the Nerve for the arytenoid muscle also had a branch going to the lateral cricoarytenoid muscle. The arytenoid muscle also received from one to three pairs of branches from the posterior division of the Internal Laryngeal Nerve; these were interconnected ipsi- and contralaterally and were also connected to the two branches coming from the recurrent Laryngeal Nerve. The lateral cricoarytenoid muscle received from one to six branches from the recurrent Nerve, but in 5.8% of cases, it also received a twig from a connecting branch between the recurrent Nerve and the external (5.6%) or the Internal Laryngeal Nerves (0.2%). The thyroarytenoid muscle received from one to four branches from the recurrent Nerve, but in 5.6% of cases, it also received a twig from a connecting branch between the recurrent Nerve with the external (4.6%) or the Internal (1%) Laryngeal Nerves. Conclusion: No abductor or adductor division of the recurrent Laryngeal Nerve was found in the present study. In 88% of cases, the Nerve supply to the arytenoid muscle (adductor) and the posterior cricoarytenoid muscle (abductor) arose from a common trunk, which in 8% of cases, also had a branch to the lateral cricoarytenoid muscle. Furthermore, the high incidence of branches innervating the adductor muscles from connections between the recurrent Laryngeal Nerve and the Internal and external Laryngeal Nerves led us to reconsider the contribution of these Nerves in the supply to this muscle group.
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An anatomical study of anastomoses between the Laryngeal Nerves.
The Laryngoscope, 1999Co-Authors: José Ramón Sañudo, Eva Maranillo, Cesar Orus, Xavier León, Rosa‐maría Mirapeix, Miquel QuerAbstract:Objective: To systematize the anatomy of the connecting branches between Laryngeal Nerves. Methods: Microdissection of 90 larynges obtained from necropsies (57 men and 33 women; age range, 41–95 y). Results: Anastomoses between the Internal and recurrent Nerves appeared in four different patterns: 1) Galen's anastomosis, as the connection between the dorsal branches of both Nerves (100%); 2) arytenoid plexus, as the connection between the arytenoid branches of both Nerves, in relation with the arytenoid muscle, and divided in a deep part (100%) and a superficial part (86%); 3) cricoid anastomosis, previously only described in cows, located in the front of the cricoid lamina (6/10 cases); and 4) thyroarytenoid anastomosis, as the connection of a descending branch of the Internal Laryngeal Nerve and an ascending branch of the recurrent Nerve (14%). Anastomosis between the Internal Laryngeal and the external Laryngeal Nerves appeared as a connecting branch throughout the foramen thyroideum (21%). Anastomosis between the external Laryngeal and recurrent Nerves appeared as a connecting branch throughout the cricothyroid muscle (68%). Conclusion: At least two anastomoses (Galen's anastomosis and arytenoid plexus) appeared in 21% of hemilarynges, and 79% of cases had three or more anastomoses between the Laryngeal Nerves. The different prevalence of this complex anastomotic pattern suggests functional differences in the sensory and motor innervation of individual subjects. Key Words: Larynx, innervation, anastomosis, Nerves.
Miquel Quer - One of the best experts on this subject based on the ideXlab platform.
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variability in Nerve patterns of the adductor muscle group supplied by the recurrent Laryngeal Nerve
Laryngoscope, 2005Co-Authors: Eva Maranillo, Cesar Orus, Miquel Quer, Xavier León, José Ramón SañudoAbstract:Introduction: Accurate knowledge of the Nerve supply of each individual muscle is needed to achieve a successful selective reinnervation of the larynx. The aim of the present work was to study the Nerve supply of the adductor Laryngeal muscles supplied by the recurrent Laryngeal Nerve. Study Design: Morphologic study of human larynges. Methods: The muscular Nerve supply was studied in a total sample of 75 human larynges obtained from necropsies (47 males and 28 females, age range from 41–95 years) and examined by careful dissection using a surgical microscope. Results: The arytenoid muscle received one branch from each recurrent Nerve. In 88% of cases, this branch arose in a common trunk with the upper branch of the posterior cricoarytenoid muscle. In 8% of cases, the Nerve for the arytenoid muscle also had a branch going to the lateral cricoarytenoid muscle. The arytenoid muscle also received from one to three pairs of branches from the posterior division of the Internal Laryngeal Nerve; these were interconnected ipsi- and contralaterally and were also connected to the two branches coming from the recurrent Laryngeal Nerve. The lateral cricoarytenoid muscle received from one to six branches from the recurrent Nerve, but in 5.8% of cases, it also received a twig from a connecting branch between the recurrent Nerve and the external (5.6%) or the Internal Laryngeal Nerves (0.2%). The thyroarytenoid muscle received from one to four branches from the recurrent Nerve, but in 5.6% of cases, it also received a twig from a connecting branch between the recurrent Nerve with the external (4.6%) or the Internal (1%) Laryngeal Nerves. Conclusion: No abductor or adductor division of the recurrent Laryngeal Nerve was found in the present study. In 88% of cases, the Nerve supply to the arytenoid muscle (adductor) and the posterior cricoarytenoid muscle (abductor) arose from a common trunk, which in 8% of cases, also had a branch to the lateral cricoarytenoid muscle. Furthermore, the high incidence of branches innervating the adductor muscles from connections between the recurrent Laryngeal Nerve and the Internal and external Laryngeal Nerves led us to reconsider the contribution of these Nerves in the supply to this muscle group.
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An anatomical study of anastomoses between the Laryngeal Nerves.
The Laryngoscope, 1999Co-Authors: José Ramón Sañudo, Eva Maranillo, Cesar Orus, Xavier León, Rosa‐maría Mirapeix, Miquel QuerAbstract:Objective: To systematize the anatomy of the connecting branches between Laryngeal Nerves. Methods: Microdissection of 90 larynges obtained from necropsies (57 men and 33 women; age range, 41–95 y). Results: Anastomoses between the Internal and recurrent Nerves appeared in four different patterns: 1) Galen's anastomosis, as the connection between the dorsal branches of both Nerves (100%); 2) arytenoid plexus, as the connection between the arytenoid branches of both Nerves, in relation with the arytenoid muscle, and divided in a deep part (100%) and a superficial part (86%); 3) cricoid anastomosis, previously only described in cows, located in the front of the cricoid lamina (6/10 cases); and 4) thyroarytenoid anastomosis, as the connection of a descending branch of the Internal Laryngeal Nerve and an ascending branch of the recurrent Nerve (14%). Anastomosis between the Internal Laryngeal and the external Laryngeal Nerves appeared as a connecting branch throughout the foramen thyroideum (21%). Anastomosis between the external Laryngeal and recurrent Nerves appeared as a connecting branch throughout the cricothyroid muscle (68%). Conclusion: At least two anastomoses (Galen's anastomosis and arytenoid plexus) appeared in 21% of hemilarynges, and 79% of cases had three or more anastomoses between the Laryngeal Nerves. The different prevalence of this complex anastomotic pattern suggests functional differences in the sensory and motor innervation of individual subjects. Key Words: Larynx, innervation, anastomosis, Nerves.
Gloria Chi-fishman - One of the best experts on this subject based on the ideXlab platform.
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Thermomechanical facilitation of swallowing evoked by electrical Nerve stimulation in cats
Dysphagia, 1994Co-Authors: Gloria Chi-fishman, Norman F. Capra, Gerald N. MccallAbstract:Application of a cold metal probe to the anterior faucial pillar has been reported to improve swallowing in some patients with dysphagia. Although a variety of stimuli contribute to the initiation of swallowing, the effects of a controlled, cold-thermal stimulus combined with mechanical stimulation have not been examined. It is known that simultaneous stimulation of the glossopharyngeal Nerve (IX) and the superior Laryngeal Nerve may summate to facilitate swallowing in the cat. The goal of this study was to determine whether thermomechanical stimulation of the mucosa innervated by IX would interact with threshold electrical stimulation of the Internal Laryngeal Nerve (ILN) to augment the swallowing response in cats. Four experimental conditions were tested over 24 trials in 4 pentobarbital-anesthetized cats. These included electrical stimulation of ILN, mechanical stimulation of the anterior faucial pillar with a thermode at ambient (room) temperature, concurrent ambient-mechanical and electrical stimulation, and concurrent cold-mechanical and electrical stimulation. Tissue was cooled to 8.9°C during cold-mechanical-electrical stimulation and 25.3°C during ambient-mechanical-electrical and ambient-mechanical alone stimulation. Ambient-mechanical stimulation alone did not produce swallowing. However, both forms of thermomechanical-electrical stimulation elicited a significantly greater number of swallows than did electrical stimulation alone. Therefore, mechanical stimulation with a thermode was capable of modifying the swallowing response in neurologically intact cats. Differences between stimulation with a probe at ambient and at cold temperatures were not significant.