Disease relevance of Recurrent Laryngeal Nerve

• Left recurrent laryngeal nerve palsy associated with primary pulmonary hypertension and patent ductus arteriosus [1].
• Two patients developed temporary recurrent laryngeal nerve paresis and one had persistent hyperparathyroidism [2].
• There were no instances of wound infection hemorrhage, recurrent laryngeal nerve injury, or hypoparathyroidism [3].
• Surgical complications consisted of 5 unilateral and 1 bilateral permanent recurrent laryngeal nerve palsies (2 intentionally resected en bloc), 1 transient hypoparathyroidism, 1 wound seroma, and 1 tracheoesophageal fistula [4].
• Permanent hypoparathyroidism (n = 4) (2.4%) and permanent recurrent laryngeal nerve palsy (n = 2) (1.2%) were observed only in patients with a grossly invasive follicular carcinoma and concomitant benign recurrent goiter [5].

High impact information on Recurrent Laryngeal Nerve

• SUMMARY BACKGROUND DATA: Few investigations have provided definitive results concerning preservation of the recurrent laryngeal nerve involved in thyroid cancer [6].
• Complications included one case of permanent hypoparathyroidism and two cases of transient bilateral recurrent laryngeal nerve palsy [7].
• Adenoviral GDNF gene transfer enhances neurofunctional recovery after recurrent laryngeal nerve injury [8].
• In contrast, capsaicin desensitization only modestly inhibited relaxations elicited by stimulation of the preganglionic parasympathetic fibres carried by the recurrent laryngeal nerves and had no effect on sympathetic nerve-induced relaxations [9].
• These vagally mediated relaxations were unaffected by propranolol but were abolished by hexamethonium or by cutting the recurrent laryngeal nerves [9].

Chemical compound and disease context of Recurrent Laryngeal Nerve

• Lidocaine block of the recurrent laryngeal nerve in adductor spasmodic dysphonia: a multidimensional assessment [10].
• The left recurrent laryngeal nerve had sufficient redundancy in its course within the tracheoesophageal groove in 10 of 10 cadavers such that it exhibited no in situ stretch during the left-sided approach to either the C4 or C7 vertebrae [11].
• Almitrine bismesylate in a dose of 0.5 mg/kg of body weight was injected intravenously three times: in the intact animals, following bilateral vagotomy (sparing the right recurrent laryngeal nerve), and after a sensory denervation of the larynx [12].
• We investigated changes in activities of phrenic nerve (PN) and the recurrent laryngeal nerve (RLN) during progressive hypoxia produced by administration of a mixture of 5% O2 in N2 and a mixture of 5% O2 in N2O in 8 vagotomized, paralyzed, and artificially ventilated cats anesthetized with halothane [13].

Anatomical context of Recurrent Laryngeal Nerve

• Characteristics of the effects of GABA on the activity of the recurrent laryngeal nerve were compared with those on that of the phrenic nerve which has previously been shown to be inhibited by the application of GABA to the ventral surface of the medulla [14].
• Stimulation of the recurrent laryngeal nerve was performed using superficial electrodes placed at the neck (midline between jugular notch and cricoid cartilage) using train-of-four (TOF) stimulation every 12 s [15].
• We conclude that laryngeal secretion can be significantly altered reflexly by stimulation of laryngeal sensory nerve endings and peripheral chemoreceptors, that both superior and recurrent laryngeal nerves convey cholinergic outflow to laryngeal submucosal glands, and that nicotine acting locally activates laryngeal submucosal glands [16].
• CONCLUSIONS: The recurrent laryngeal nerve on the right side is highly vulnerable to injury if ligature of the inferior thyroid vessels is not performed as laterally as possible or if retraction of the midline structures along with the recurrent laryngeal nerve is not performed intermittently [17].
• Restoring vocal fold movement after transection and immediate suturing of the recurrent laryngeal nerve with local application of basic fibroblast growth factor: an experimental study in the rat [18].

Associations of Recurrent Laryngeal Nerve with chemical compounds

• There are also paraganglion cells within the recurrent laryngeal nerve that contain catecholamines and are surrounded by substance P immunoreactive fibres [19].
• The recurrent laryngeal nerve was stimulated supramaximally with single twitch stimulation (0.1 Hz) for onset, and train-of-four stimulation every 12 s during offset of neuromuscular blockade was produced by 0.1 mg/kg mivacurium [20].
• The incidence of conduction block by lidocaine 0.3 and 0.6 mM (8.1-16.2 mg/dl) was determined on 35 individual axons in dissected filaments of rabbit recurrent laryngeal nerve (RLN) in which the control conduction velocity ranged from 28 to 77 m/sec [21].
• The pattern of response of 45 single postganglionic sympathetic axons dissected from the right recurrent laryngeal nerve was examined in chloralose-anesthetized cats [22].
• The glutamate-containing laryngeal motoneurons were identified by double labeling using the retrograde tracing of True blue from the cut end of the recurrent laryngeal nerve and immunocytochemistry of glutamate [23].

Gene context of Recurrent Laryngeal Nerve

• These results indicate that adenovirus-mediated BDNF and GDNF gene transfer may prevent the degeneration of motoneurons in humans after either vagal nerve injury or recurrent laryngeal nerve injury [24].
• METHODS: The effects of nonviral gene transfer for the delivery of hIGF-1 were evaluated in rats treated immediately following recurrent laryngeal nerve transection and repair and in rats receiving a delayed treatment schedule, 30 days after nerve transection and repair [25].
• Growth associated protein-43 mRNA expression in nucleus ambiguus motoneurons after recurrent laryngeal nerve injury in the rat [26].
• Permanent recurrent laryngeal nerve injury occurred in 0.8% and permanent hypoparathyroidism in 13% of patients [27].
• On the other hand, choline acetyltransferase (ChAT) immunoreactivity was found in all the laryngeal motoneurons which were similarly identified as the origin of the recurrent laryngeal nerve using retrograde tracing of True blue [23].

Analytical, diagnostic and therapeutic context of Recurrent Laryngeal Nerve

• These factors were: goitre for more than 5 years, preoperative recurrent laryngeal nerve palsy, significant tracheal narrowing and/or deviation, retrosternal extension, difficult endotracheal intubation and thyroid cancer [28].
• Total thyroidectomy is not frequently performed in cases of benign disease because of the associated risk of postoperative hypoparathyroidism and recurrent laryngeal nerve (RLN) damage [29].
• Surprisingly, none of the patients with more than one reoperation, only two of the five patients with permanent recurrent laryngeal nerve injury, and only one of the four patients with persistent hypoparathyroidism were dissatisfied overall [30].
• Surgical complications included 20 cases of transient recurrent laryngeal nerve palsy, 16 cases of transient and one of permanent hypoparathyroidism, and one respiratory obstruction due to bilateral recurrent laryngeal nerve palsy that required temporary tracheostomy [31].
• OBJECTIVE: To evaluate a new method of nerve-muscle transplantation (NMT) to the paraglottic space after resection of the recurrent laryngeal nerve (RLN) during surgery for thyroid cancer [32].

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