Journal of voice : official journal of the Voice Foundation · 2026
Ultrastructural and Automated Vocal Fold Tracking Study in Recurrent Laryngeal Nerve Injury Models.
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Ma Yanli, Xing Lu, Ren Xiaoyong
Аннотация
OBJECTIVE: This study aims to assess nerve regeneration characteristics and their impact on vocal fold (VF) movement after unilateral recurrent laryngeal nerve (URLN) injuries to inform clinical treatment strategies.
METHODS: Four types of URLN injury models in rabbits were created: clamp, electrocautery, transection, and ligation. Nerve damage and regeneration were evaluated using electron microscopy at 2, 4, 8, and 12 weeks postinjury. VF movement range and speed were assessed using tracking software.
RESULTS: The N-ratio (the ratio of myelinated axon area to total nerve trunk area) and myelinated axon density (MAD, the number of axons per unit area): clamp group were the highest at all times compared to the other groups. Postinjury, the electrocautery group was higher than the transection and ligation groups, except at 2 weeks. In the clamp and electrocautery groups, N-ratio and MAD increased between 4 and 8 weeks postinjury. At 4 weeks, 100% of the clamp group and 66.7% of the electrocautery group showed partial recovery of injured VF movement. Compared to the normal VF, the affected VF's mean motion range (MMR) was 22% less (P < 0.05), and mean motion speed (MMS) was 58% slower (P < 0.05). At 8 weeks, MMR was 7% less (P < 0.05), and MMS was 41% slower (P < 0.05). At 12 weeks, MAD started to decrease. However, the N-ratio continued to increase. MMR was 2% lower (P > 0.05), and MMS was 24% slower (P < 0.05).
CONCLUSION: The severity of RLN injuries was as follows: ligation > transection > electrocautery > clamp injury. Recovery of VF motion range preceded recovery of motion speed. Asynchronous motion of bilateral VFs was a characteristic feature of RLN injury repair.
METHODS: Four types of URLN injury models in rabbits were created: clamp, electrocautery, transection, and ligation. Nerve damage and regeneration were evaluated using electron microscopy at 2, 4, 8, and 12 weeks postinjury. VF movement range and speed were assessed using tracking software.
RESULTS: The N-ratio (the ratio of myelinated axon area to total nerve trunk area) and myelinated axon density (MAD, the number of axons per unit area): clamp group were the highest at all times compared to the other groups. Postinjury, the electrocautery group was higher than the transection and ligation groups, except at 2 weeks. In the clamp and electrocautery groups, N-ratio and MAD increased between 4 and 8 weeks postinjury. At 4 weeks, 100% of the clamp group and 66.7% of the electrocautery group showed partial recovery of injured VF movement. Compared to the normal VF, the affected VF's mean motion range (MMR) was 22% less (P < 0.05), and mean motion speed (MMS) was 58% slower (P < 0.05). At 8 weeks, MMR was 7% less (P < 0.05), and MMS was 41% slower (P < 0.05). At 12 weeks, MAD started to decrease. However, the N-ratio continued to increase. MMR was 2% lower (P > 0.05), and MMS was 24% slower (P < 0.05).
CONCLUSION: The severity of RLN injuries was as follows: ligation > transection > electrocautery > clamp injury. Recovery of VF motion range preceded recovery of motion speed. Asynchronous motion of bilateral VFs was a characteristic feature of RLN injury repair.