Research

Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

Stephane Derrey^1,2 , Eric verin^3,4 , Annie Laquerrière⁵ , Angelique Boishardy de Barros^1,6 , Yann Lacoume¹ , Pierre Fréger² and Jean Paul Marie^1,3,6

¹Experimental Surgery Laboratory, Rouen University, School of Medicine, France

²Department of Neurosurgery, Rouen University Hospital, Charles Nicolle, France

³GRHV-EA 3830. Groupe de recherche sur le handicap ventilatoire (Ventilatory insufficiency research group), IFRMP 23, Rouen University, France

⁴Department of Physiology, Rouen University Hospital, Charles Nicolle, France

⁵Department of Pathology, Rouen University Hospital, Charles Nicolle, France

⁶Department of Otolaryngology Head and Neck Surgery, Rouen University Hospital, Charles Nicolle, France

author email corresponding author email

Respiratory Research 2006, 7:17doi:10.1186/1465-9921-7-17

Published:	27 January 2006

Abstract

Objectives

To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries.

Material and method

Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve). Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination.

Results

A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V.

Conclusion

Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.