Recurrent Laryngeal
Neuropathy
Modified first or second cervical nerve transplantation
technique for the treatment of recurrent laryngeal neuropathy
(RLN) in horses
F. Rossignol
O. Brandenberger
J. D. Perkins
J.‐P. Marie
C. Mespoulhès‐Rivière
N. G. Ducharme
Background
In horses, the only established method for reinner-
vation of the larynx is the nerve‐muscle pedicle im-
plantation, whereas in human medicine, direct nerve
implantation is a standard surgical technique for se-
lective laryngeal reinnervation in human patients suf-
fering from bilateral vocal fold paralysis.
Objectives
1. To describe a modified first or second cervical
nerve transplantation technique for the treatment of
recurrent laryngeal neuropathy (RLN) in horses and
2. evaluate the outcomes of reinnervation using direct
nerve needle‐stimulation of the first cervical nerve
and exercising endoscopy before and after surgery.
Study design
Case series
Methods
Nerve transplantation surgery, in which the first or sec-
ond cervical nerve is tunnelled through the atrophied
left cricoarytenoideus dorsalis muscle, was performed
in combination with ipsilateral laser ventriculocordec-
tomy. Ultrasound‐guided stimulation of the first cer-
vical nerve at the level of the alar foramen was used
to confirm successful reinnervation post‐operatively.
Exercising endoscopy was performed before and after
surgery. The exercising RLN grade of the left arytenoid
was blindly determined at the highest stride frequency
for each examination.
• Volume 20 Issue 1 | April 2018 •
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