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Gayle E Woodson - One of the best experts on this subject based on the ideXlab platform.
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Spontaneous Laryngeal Reinnervation After Recurrent Laryngeal or Vagus Nerve Injury
2016Co-Authors: Gayle E WoodsonAbstract:Objectives: The status of innervation in patients with Laryngeal Paralysis is somewhat controversial. Electromyographic activity has been frequently documented in the Laryngeal muscles of patients with Laryngeal Paralysis, and animal experi-ments report a strong propensity for reinnervation after Laryngeal nerve injury. However, a study of intraoperative elec-tromyography performed in patients during reinnervation surgery failed to document activity with stimulation of the re-current Laryngeal nerve (RLN). Noting the long-observed differences in the symptoms of patients with vagus nerve injury and those with RLN injury, I hypothesized that reinnervation is influenced by the site of nerve injury. Methods: Cats were sacrificed at various intervals after resection of 1 cm of either the RLN or the vagus nerve, without any attempt to repair the nerve. Results: Four months after RLN resection, distal nerve biopsy revealed unmyelinated axons scattered through fibrous tis-sue. By 6 months, myelinated axons were organized, and electromyographic and histologic examination showed prefer-ential reinnervation of the thyroarytenoid muscle. After vagotomy, the RLN was fibrotic and no axons were present. Both the thyroarytenoid and posterior cricoarytenoid muscles were fibrotic and had no electromyographic activity. Conclusions: The results confirm the strong propensity for Laryngeal reinnervation after RLN injury, but not after vagus nerve injury. Preferential reinnervation of adductor muscles may account for a medial position of the paralyzed vocal fold
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quantitative assessment of Laryngeal muscle morphology after recurrent Laryngeal nerve injury right vs left differences
Laryngoscope, 2008Co-Authors: Gayle E Woodson, Larry F Hughes, Robert H HelfertAbstract:Objectives/Hypothesis: Reports of Laryngeal response to denervation are inconsistent. Some document atrophy and fibrosis in denervated Laryngeal muscles, whereas others indicate resistance to atrophy. Spontaneous reinnervation has also been documented. The goal of this study was to clarify the effects of nerve injury and reinnervation on thyroarytenoid (TA) and posterior cricoarytenoid (PCA) muscles. Study Design: Laboratory experiment. Methods: TA and PCA muscles of cats were harvested 5 to 6 months after transecting right or left recurrent Laryngeal nerve (RLN). Images of muscle cross-sections were acquired and studied using an image analysis workstation. Cross-sectional areas as well as total cross-sectional area of randomly selected muscle fibers were recorded. Results: TA reinnervation was robust on both sides, but there was less reinnervation of the PCA muscle after left-sided RLN lesion than after right-sided injury. Conclusions: Differences in reinnervation after RLN injury could contribute to the higher clinical incidence of left- vs. right-sided Laryngeal Paralysis.
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spontaneous Laryngeal reinnervation after recurrent Laryngeal or vagus nerve injury
Annals of Otology Rhinology and Laryngology, 2007Co-Authors: Gayle E WoodsonAbstract:Objectives:The status of innervation in patients with Laryngeal Paralysis is somewhat controversial. Electromyographic activity has been frequently documented in the Laryngeal muscles of patients with Laryngeal Paralysis, and animal experiments report a strong propensity for reinnervation after Laryngeal nerve injury. However, a study of intraoperative electromyography performed in patients during reinnervation surgery failed to document activity with stimulation of the recurrent Laryngeal nerve (RLN). Noting the long-observed differences in the symptoms of patients with vagus nerve injury and those with RLN injury, I hypothesized that reinnervation is influenced by the site of nerve injury.Methods:Cats were sacrificed at various intervals after resection of 1 cm of either the RLN or the vagus nerve, without any attempt to repair the nerve.Results:Four months after RLN resection, distal nerve biopsy revealed unmyelinated axons scattered through fibrous tissue. By 6 months, myelinated axons were organized,...
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configuration of the glottis in Laryngeal Paralysis i clinical study
Laryngoscope, 1993Co-Authors: Gayle E WoodsonAbstract:: It is widely accepted in the American literature that the cricothyroid muscle is responsible for the paramedian position of the vocal fold in recurrent Laryngeal nerve Paralysis. However, support in the literature for this theory is not conclusive, and the cadaveric vocal fold position expected after lesions of the vagus nerve has also been reported in patients with an intact superior Laryngeal nerve. This study compares the configuration of the glottis in patients with unilateral Paralysis due to known lesions of either the recurrent Laryngeal or vagus nerve. Normal subjects were studied as controls. Results indicate that the alteration of glottic configuration in Laryngeal Paralysis cannot be adequately characterized by standard terms of vocal fold position. The paralyzed vocal fold is shortened, with anterior rotation of the arytenoid. Patients with vagus nerve lesions had a statistically insignificant tendency for a more lateral vocal fold position, but a discrete difference in position between the two groups was not identified. This study also confirms prior observations that paralyzed vocal folds are frequently not denervated. These findings have significant implications for management of Laryngeal Paralysis.
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configuration of the glottis in Laryngeal Paralysis ii animal experiments
Laryngoscope, 1993Co-Authors: Gayle E WoodsonAbstract:It is widely believed that in isolated recurrent Laryngeal nerve Paralysis, the paralyzed vocal fold assumes a median or paramedian position, due to the action of the cricothyroid muscle. A review of the literature reveals that support for this theory is not conclusive and, in particular, experiments indicate that the cricothyroid muscle does not appreciably affect vocal fold position in acute Paralysis. The research in this study compares the configuration of the glottis in chronic unilateral recurrent Laryngeal nerve Paralysis in cats, with and without concomitant denervation of the cricothyroid muscle. Results indicate that vocal fold position is not determined by the cricothyroid muscle. Incomplete denervation of intrinsic Laryngeal muscles as well as synkinetic reinnervation appear to be significant factors in determining vocal fold position in chronic Laryngeal Paralysis.
Kaspar Matiasek - One of the best experts on this subject based on the ideXlab platform.
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Juvenile-onset polyneuropathy in American Staffordshire Terriers.
Journal of veterinary internal medicine, 2018Co-Authors: Hélène Vandenberghe, Catherine Escriou, Marco Rosati, Laura Porcarelli, Alfredo Recio Caride, Sònia Añor, Gualtiero Gandini, Daniele Corlazzoli, Jean-laurent Thibaud, Kaspar MatiasekAbstract:Background: The only hereditary neurologic disorder described so far in American Staffordshire Terriers is adult-onset cerebellar degeneration secondary to ceroid lipofuscinosis. We have seen several dogs with a newly recognized neurological disease characterized by locomotor weakness with or without respiratory signs and juvenile onset consistent with degenerative polyneuropathy of genetic origin. Objectives: To characterize a novel polyneuropathy in juvenile American Staffordshire Terriers. Animals: Fourteen American Staffordshire Terriers presented with clinical signs consistent with juvenile-onset polyneuropathy at 5 veterinary hospitals between May 2005 and July 2017. Methods: Case series. Dogs were included retrospectively after a diagnosis of degenerative polyneuropathy had been confirmed by nerve biopsy. Clinical, pathological, electrophysiological, histological data, and outcome were reviewed and a pedigree analysis performed. Results: All dogs displayed clinical signs of neuromuscular disease with generalized motor and sensory involvement, associated with focal signs of Laryngeal Paralysis (10/14 dogs) and megaesophagus (1/14 dogs). Histopathological findings were consistent with degenerative polyneuropathy. Follow-up was available for 11 dogs, and 3 dogs were euthanized shortly after diagnosis. In these 11 dogs, the disease was slowly progressive and the animals maintained good quality of life with ability to walk. Pedigree analysis was mostly consistent with an autosomal recessive mode of inheritance. Conclusions and Clinical Importance: Juvenile polyneuropathy, associated with Laryngeal Paralysis, is a newly described entity in American Staffordshire Terriers, and results from degenerative neuropathy. When surgery for Laryngeal Paralysis is performed, lifespan may be similar to that of normal dogs even though affected dogs have locomotor disturbance.
Paul W Flint - One of the best experts on this subject based on the ideXlab platform.
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proteomic analysis of rat Laryngeal muscle following denervation
Proteomics, 2005Co-Authors: Mohamed Lehar, Robin A Samlan, Paul W FlintAbstract:Laryngeal muscle atrophy induced by nerve injury is a major factor contributing to the disabling symptoms associated with Laryngeal Paralysis. Alterations of global proteins in rat Laryngeal muscle following denervation were, therefore, studied using proteomic techniques. Twenty-eight adult Sprague-Dawley rats were divided into normal control and denervated groups. The thyroarytenoid (TA) muscle was excised 60 days after right recurrent Laryngeal nerve was resected. Protein separation and identification were preformed using 2-DE and MALDI-MS with database search. Forty-four proteins were found to have significant alteration in expression level after denervation. The majority of these proteins (57%), most of them associated with energy metabolism, cellular proliferation and differentiation, signal transduction and stress reaction, were decreased levels of expression in denervated TA muscle. The remaining 43% of the proteins, most of them involved with protein degradation, immunoreactivity, injury repair, contraction, and microtubular formation, were found to have increased levels of expression. The protein modification sites by phosphorylation were detected in 22% of the identified proteins that presented multiple-spot patterns on 2-D gel. Significant changes in protein expression in denervated Laryngeal muscle may provide potential therapeutic strategies for the treatment of Laryngeal Paralysis.
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timing of human insulin like growth factor 1 gene transfer in reinnervating Laryngeal muscle
Laryngoscope, 2004Co-Authors: Hideki Nakagawa, Akihiro Shiotani, Michael E Coleman, Bert W Omalley, Paul W FlintAbstract:Objectives/Hypothesis The authors have designed a rat Laryngeal Paralysis model to study gene transfer strategies using a muscle-specific expression system to enhance local delivery of human insulin-like growth factor-1 (hIGF-1). In preliminary studies, a nonviral vector containing the α-actin promoter and human hIGF-1 sequence produced both neurotrophic and myotrophic effects 1 month after single injection of plasmid formulation into paralyzed rat thyroarytenoid muscle in vivo. Based on these findings, it is hypothesized that the effects of hIGF-1 will enhance the results of Laryngeal muscle innervation procedures. The timing of gene delivery relative to nerve repair is likely to be important, to optimize the results. Study Design Prospective analysis. Methods The effects of nonviral gene transfer for the delivery of hIGF-1 were evaluated in rats treated immediately following recurrent Laryngeal nerve transection and repair and in rats receiving a delayed treatment schedule, 30 days after nerve transection and repair. Gene transfer efficiency was determined using polymerase chain reaction and reverse transcriptase–polymerase chain reaction techniques. Muscle fiber diameter, motor endplate length, and percentage of motor endplates with nerve contact were examined to assess hIGF-1 trophic effects. Results Compared with reinnervated untreated control samples, both early and delayed hIGF-1 transfer resulted in significant increase in muscle fiber diameter. Motor endplate length was significantly decreased and nerve/motor endplate contact was significantly increased following delayed gene transfer, but not after early treatment. Conclusion We infer from results of the study that delayed hIGF-1 gene transfer delivered by a single intramuscular injection will enhance the process of muscle reinnervation. The clinical relevance of these findings supports the future application of gene therapy using nonviral vectors for management of Laryngeal Paralysis and other peripheral nerve injuries.
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reinnervation of motor endplates and increased muscle fiber size after human insulin like growth factor i gene transfer into the paralyzed larynx
Human Gene Therapy, 1998Co-Authors: Akihiro Shiotani, Michael E Coleman, Bert W Omalley, Hector W Alila, Paul W FlintAbstract:ABSTRACT Current surgical strategies for the treatment of Laryngeal Paralysis are limited by the muscle atrophy associated with denervation. Moreover, attempts at reinnervation have not effected si...
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correlation between stroboscopy and electromyography in Laryngeal Paralysis
Annals of Otology Rhinology and Laryngology, 1993Co-Authors: John Kokesh, Lawrence R Robinson, Paul W Flint, Charles W CummingsAbstract:Twenty patients with vocal fold motion impairment were reviewed to correlate the findings of electromyography (EMG) and stroboscopy. The causes of motion impairment were idiopathic, previous surgery with recurrent Laryngeal nerve injury, neck and skull base trauma, and neoplasm. The EMG studies were analyzed to assess the status of innervation of the immobile vocal fold. The presence or absence of the mucosal wave prior to therapeutic intervention was determined with stroboscopic examination. Eight of 10 patients with EMG evidence of reinnervation or partial denervation were found to have mucosal waves, and 3 of 10 patients with EMG evidence of denervation were found to have mucosal waves. Six patients developed mucosal waves after surgical medialization, despite evidence of denervation by EMG criteria. These findings support the premise that tension and subglottic pressure, rather than status of innervation, determine the presence of the mucosal wave.
Hélène Vandenberghe - One of the best experts on this subject based on the ideXlab platform.
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Juvenile-onset polyneuropathy in American Staffordshire Terriers.
Journal of veterinary internal medicine, 2018Co-Authors: Hélène Vandenberghe, Catherine Escriou, Marco Rosati, Laura Porcarelli, Alfredo Recio Caride, Sònia Añor, Gualtiero Gandini, Daniele Corlazzoli, Jean-laurent Thibaud, Kaspar MatiasekAbstract:Background: The only hereditary neurologic disorder described so far in American Staffordshire Terriers is adult-onset cerebellar degeneration secondary to ceroid lipofuscinosis. We have seen several dogs with a newly recognized neurological disease characterized by locomotor weakness with or without respiratory signs and juvenile onset consistent with degenerative polyneuropathy of genetic origin. Objectives: To characterize a novel polyneuropathy in juvenile American Staffordshire Terriers. Animals: Fourteen American Staffordshire Terriers presented with clinical signs consistent with juvenile-onset polyneuropathy at 5 veterinary hospitals between May 2005 and July 2017. Methods: Case series. Dogs were included retrospectively after a diagnosis of degenerative polyneuropathy had been confirmed by nerve biopsy. Clinical, pathological, electrophysiological, histological data, and outcome were reviewed and a pedigree analysis performed. Results: All dogs displayed clinical signs of neuromuscular disease with generalized motor and sensory involvement, associated with focal signs of Laryngeal Paralysis (10/14 dogs) and megaesophagus (1/14 dogs). Histopathological findings were consistent with degenerative polyneuropathy. Follow-up was available for 11 dogs, and 3 dogs were euthanized shortly after diagnosis. In these 11 dogs, the disease was slowly progressive and the animals maintained good quality of life with ability to walk. Pedigree analysis was mostly consistent with an autosomal recessive mode of inheritance. Conclusions and Clinical Importance: Juvenile polyneuropathy, associated with Laryngeal Paralysis, is a newly described entity in American Staffordshire Terriers, and results from degenerative neuropathy. When surgery for Laryngeal Paralysis is performed, lifespan may be similar to that of normal dogs even though affected dogs have locomotor disturbance.
Lucian Sulica - One of the best experts on this subject based on the ideXlab platform.
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the natural history of idiopathic unilateral vocal fold Paralysis evidence and problems
Laryngoscope, 2008Co-Authors: Lucian SulicaAbstract:Objectives/Hypothesis:To identify clinical evidence regarding outcome and duration of unilateral idiopathic vocal fold Paralysis (IVFP).Study Design:Literature review.Methods:Medline search using the terms “vocal fold Paralysis,” “Laryngeal Paralysis,” “vagal Paralysis,” and “recurrent nerve paralys
