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Surgical anatomy of the ansa cervicalis nerve: which branch to use for laryngeal reinnervation in humans?

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Abstract

Purpose

The aim of this study has been to obtain some data for the selection of which branch of the ansa cervicalis nerve (AC) could be an attractive candidate for a laryngeal reinnervation using AC to recurrent laryngeal nerve (RLN) neurorrhaphy.

Methods

The AC was dissected in ten human head cadavers with an operating microscope. A vagal nerve stimulation was conducted during a bilateral thyroidectomy with normal vocal fold mobility in ten patients using a NIM Medtronic System® to record phasic activity within the thyroarytenoid muscle (vocal fold adduction) and one of the infrahyoid muscle (sternothyroid muscle or sternohyoid muscle).

Results

Despite reported variations of the roots of AC and location of its loop, the lower portion of the STM and SHM was innervated by a prominent common trunk in 80 % of cases, in a close vicinity of the RLN with an excellent size match to the RLN for a tension-free anastomosis. The STM displays slight but significant electrical activity during vocal fold adduction.

Conclusion

The common trunk of the SHM and STM is the prime choice for laryngeal reinnervation using AC-RLN non-selective anastomosis. If the main trunk is missing, the branch to the STM can be an attractive candidate.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Laboratory of Human Anatomy, Department of Otolaryngology Head and Neck Surgery, University of Saint-Etienne, Saint-Etienne, France

    Jean Michel Prades, M. Gavid, M. D. Dubois & A. T. Timoshenko

  2. Department of Cyto-pathology, Centre Hospitalo-Universitaire (CHU) de Saint Etienne, Saint Etienne, France

    J. M. Dumollard & M. Peoc’h

Authors
  1. Jean Michel Prades
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  2. M. Gavid
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  3. M. D. Dubois
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  4. J. M. Dumollard
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  5. A. T. Timoshenko
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  6. M. Peoc’h
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Correspondence to Jean Michel Prades.

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Prades, J.M., Gavid, M., Dubois, M.D. et al. Surgical anatomy of the ansa cervicalis nerve: which branch to use for laryngeal reinnervation in humans?. Surg Radiol Anat 37, 139–145 (2015). https://doi.org/10.1007/s00276-014-1355-x

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  • DOI: https://doi.org/10.1007/s00276-014-1355-x

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