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Recurrent laryngeal nerve regeneration using an oriented collagen scaffold containing Schwann cells
Author(s) -
Chitose Shunichi,
Sato Kiminori,
Fukahori Mioko,
Sueyoshi Shintaro,
Kurita Takashi,
Umeno Hirohito
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26389
Subject(s) - recurrent laryngeal nerve , epineurium , regeneration (biology) , anatomy , synkinesis , scaffold , reinnervation , transplantation , pathology , medicine , chemistry , microbiology and biotechnology , biology , surgery , biomedical engineering , sciatic nerve , alternative medicine , thyroid , palsy
Objectives/Hypothesis Regeneration of the recurrent laryngeal nerve (RLN), which innervates the intrinsic laryngeal muscles such that they can perform complex functions, is particularly difficult to achieve. Synkinesis after RLN neogenesis leads to uncoordinated movement of laryngeal muscles. Recently, some basic research studies have used cultured Schwann cells (SCs) to repair peripheral nerve injuries. This study aimed to regenerate the RLN using an oriented collagen scaffold containing cultured SCs. Study Design Preliminary animal experiment. Methods A 10‐mm‐long autologous canine cervical ansa was harvested. The nerve tissue was scattered and subcultured on oriented collagen sheets in reduced serum medium. After verifying that the smaller cultivated cells with high nucleus‐cytoplasm ratios were SCs, collagen sheets with longitudinally oriented cells were rolled and inserted into a 20‐mm collagen conduit. The fabricated scaffolds containing SCs were autotransplanted to a 20‐mm deficient RLN, and vocal fold movements and histological characteristics were observed. Results Scaffolds containing cultured SCs were successfully fabricated. Immunocytochemical examination revealed that these isolated and cultured cells, identified as SCs, expressed S‐100 protein and GFAP but not vimentin. The orientation of SCs matched that of the oriented collagen sheet. Two months after successful transplantation, laryngeal endoscopy revealed coordinated movement of the bilateral vocal folds by external stimulation under light general anesthesia. Hematoxylin and eosin staining showed that the regenerated RLN lacked epineurium surrounding the nerve fibers and was interspersed with collagen fibers. Myelin protein zero was expressed around many axons. Conclusions Partial regeneration of RLN was achieved through the use of oriented collagen scaffolding. Level of Evidence NA Laryngoscope , 127:1622–1627, 2017