Article

Tacrolimus enhances the recovery of normal laryngeal muscle fibre distribution after reinnervation

Otorhinolaryngology and Head and Neck Surgery Department, Rouen University Hospital, France.
The Journal of Laryngology & Otology (Impact Factor: 0.7). 09/2012; 126(11):1155-8. DOI: 10.1017/S0022215112001788
Source: PubMed

ABSTRACT Objectives: To assess the recovery of various muscle fibre types in the posterior cricoarytenoid muscle after laryngeal reinnervation in the rat, and to determine the influence of tacrolimus on this process. Methods: Four groups of rats underwent resection and anastomosis of the left vagus nerve, and were administered either tacrolimus at a low dose or an immunosuppressive dose, or cyclosporin A at a low dose or an immunosuppressive dose. A fifth group received surgery alone, and a sixth group received neither surgery nor drug treatment (healthy group). Muscles were removed for immunohistochemical analysis 45 days after surgery. Results: There was no difference in the proportion of types 1, 2a and 2b muscle fibres, comparing the immunosuppressive tacrolimus group and the healthy group, whereas there were fewer type 1 fibres in the group receiving surgery alone, compared with the healthy group (7 vs 12.1 per cent, respectively; p = 0.0303). Conclusion: Tacrolimus enhanced the recovery of normal laryngeal muscle fibres after reinnervation in the rat, indicating a possible role in laryngeal transplantation.

Download full-text

Full-text

Available from: Philippe Gorphe, Oct 28, 2014
0 Followers
 · 
79 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The functional neurotrophic effects of systemic tacrolimus in a sub-immunosuppressive regimen in the minipig model of laryngeal reinnervation were investigated. Methods: Right recurrent laryngeal nerve transection and phrenic-abductor branch of recurrent la-ryngeal nerve anastomosis were performed in two minipigs that were administered low-dose oral tac-rolimus (0.125 mg/kg) for one month. Vocal cord abduction at four months was rated by two blinded expert assessors on a four-point Likert scale from poor (1) to complete (4), and compared with five fully matched historical control animals that received the same surgery but no other interventions. Results: Right vocal cord abduction was more complete in tacrolimus-treated animals than controls (mean abduction score 2.3 vs. 1.5, p=0.019). Conclusion: Tacrolimus may have an important role in laryngeal reinnervation following allograft transplantation, and low-dose regimens may have applications in cranial and peripheral nerve injuries or in the reinnervation of tissue-engineered laryngeal constructs, but further studies are required.
    09/2013; DOI:10.5455/aces.20130427050406
  • [Show abstract] [Hide abstract]
    ABSTRACT: The treatment of unilateral vocal fold palsy (UVFP) or bilateral vocal fold palsy (BVFP) has been the subject of debate and experiment for 150 years. To date, dozens of different surgical methods have been described to reinnervate this most complex of organs, the larynx. As yet, there is no consensus on the most functionally effective method of reinnervation. However, it is a rapidly expanding area of research and remains an area of controversy. Indications for reinnervation for both UVFP and BVFP are still evolving and our understanding of the neuromuscular supply to the larynx continues to expand. What may have been considered unacceptable results from previous studies with one pathology may actually be of benefit in patients with different pathologies. This uncertainty of treatment options and potential outcomes can be confusing. In addition alternative techniques have been postulated as mainstays or adjuncts of treatment to the stalwart of reinnervation, neurorrhaphy. Determining what the correct treatment for an individual patient should be is still a gray area. With this in mind, this article reviews the evolution of laryngeal reinnervation, reviews the current state of the science, and suggests directions in which it might move in the future.
    04/2014; DOI:10.1016/j.jvoice.2014.01.014