OBJECTIVES/HYPOTHESIS: Recurrent laryngeal nerve (RLN) transection injuries may occur during thyroidectomy and other surgical procedures. Laser nerve welding has been shown to cause less technique-related axonal damage than the traditional suture method. We compared functional adductor results using these two methods of RLN repair. STUDY DESIGN: Animal model. METHODS: Canine hemilarynges underwent pretreatment testing of laryngeal adductor function, followed by RLN transection and repair using potassium titanyl phosphate (KTP) laser welding (n = 8) or microneural suture (n = 16) techniques. Six months later, adductor function was measured again and expressed as a proportion of the pretreatment value. RESULTS: The mean laryngeal adductor pressure ratios were 82.4% (95% confidence interval [CI]: 72.8%-92.0%) for the laser repair group and 55.5% (95% CI: 49.4%-61.6%) for the suture control group, with a difference of 26.9% (95% CI: 15.3%-38.5%). Both spontaneous and stimulated glottic closure was observed in the laser welding and microsuture repair groups. CONCLUSIONS: Laser nerve welding resulted in greater strength of adduction than suture repair of an acutely transected RLN. Suture anastomosis may traumatize more axons than the laser. Stronger vocal fold adduction is associated clinically with better protection from aspiration and improved voice outcomes. KTP laser welding should be considered for anastomosis of the RLN and other nerves. LEVEL OF EVIDENCE: NA Laryngoscope, 130:1764-1769, 2020.
OBJECTIVES/HYPOTHESIS: Recurrent laryngeal nerve (RLN) transection injuries may occur during thyroidectomy and other surgical procedures. Laser nerve welding has been shown to cause less technique-related axonal damage than the traditional suture method. We compared functional adductor results using these two methods of RLN repair. STUDY DESIGN: Animal model. METHODS: Canine hemilarynges underwent pretreatment testing of laryngeal adductor function, followed by RLN transection and repair using potassium titanyl phosphate (KTP) laser welding (n = 8) or microneural suture (n = 16) techniques. Six months later, adductor function was measured again and expressed as a proportion of the pretreatment value. RESULTS: The mean laryngeal adductor pressure ratios were 82.4% (95% confidence interval [CI]: 72.8%-92.0%) for the laser repair group and 55.5% (95% CI: 49.4%-61.6%) for the suture control group, with a difference of 26.9% (95% CI: 15.3%-38.5%). Both spontaneous and stimulated glottic closure was observed in the laser welding and microsuture repair groups. CONCLUSIONS: Laser nerve welding resulted in greater strength of adduction than suture repair of an acutely transected RLN. Suture anastomosis may traumatize more axons than the laser. Stronger vocal fold adduction is associated clinically with better protection from aspiration and improved voice outcomes. KTP laser welding should be considered for anastomosis of the RLN and other nerves. LEVEL OF EVIDENCE: NA Laryngoscope, 130:1764-1769, 2020.
Authors: Brian Swendseid; Shawn Li; Jason Thuener; Rod Rezaee; Pierre Lavertu; Nicole Fowler; Chad Zender Journal: Oral Oncol Date: 2017-08-10 Impact factor: 5.337
Authors: Megan J Williams; Avinash Ayylasomayajula; Reza Behkam; Andrew J Bierhals; M Eileen Jacobs; Julia D Edgar; Randal C Paniello; Julie M Barkmeier-Kraemer; Jonathan P Vande Geest Journal: J Appl Physiol (1985) Date: 2014-12-04
Authors: Sarah M Eickmeyer; Christine K Walczak; Katherine B Myers; D Richard Lindstrom; Peter Layde; Bruce H Campbell Journal: PM R Date: 2014-05-28 Impact factor: 2.298
Authors: Antonio Lauto; Damia Mawad; Matthew Barton; Abhishek Gupta; Sabine C Piller; James Hook Journal: Biomed Eng Online Date: 2010-09-08 Impact factor: 2.819