The human Laryngeal Innervation. Revisited-The Role pf the Neural Connections
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Publication date
2018
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Wiley, NJ USA
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Martín-Oviedo C, Maranillo E, Sañudo JR, Pérez-Lloret P, Verdú E, Martínez-Guirado T, Álvarez-Montero O, Gómez Martín-Zarco JM, Vázquez T. The human laryngeal innervation revisited-the role of the neural connections. Anat Rec (Hoboken) 2019;302(4):646-651.
Abstract
In spite that vascular inconvenients or immunological rejections have been solved in relation with larynx transplant, a successful functional reinnervation has not been achieved. Some studies have suggested that
laryngeal nerve connection may contain motor fibers, which could explain unexpected evoked responses in electromyographic studies or the different positions adopted of the vocal folds after similar nerve lesions. Ten
patients with unexpected evoked responses after laryngeal nerve stimulation were selected. All the patients underwent a total laryngectomy due to oncological causes. In every case, laryngeal nerve connections were
observed. All of them were morphologic and histologic processed for choline-acetyltransferase immunohistochemistry. The presence of motor axons in the nerve connections has been demonstrated, which would explain that the motor innervation to the laryngeal muscles could be dual through these variable connections. This also would justify the difficulty of carrying out laryngeal nerve reinnervation procedures.