Comparison of primary repair and repair with polyglycolic acid coated tube in recurrent laryngeal nerve cuts (an experimental study)

• Published in: The American journal of surgery Vol. 219; no. 4; pp. 632 - 636
• Main Authors: Şentürk, Mustafa, Çakır, Murat, Tekin, Ahmet, Küçükkartallar, Tevfik, Yıldırım, Mehmet Aykut, Alkan, Selman, Fındık, Sıddıka
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2020; Elsevier Limited
• Subjects: Acids; Airway management; Animals; Axons; Axons - pathology; Coated Materials, Biocompatible; Coatings; Dissection; Edema; Endoscopy; Euthanasia; General anesthesia; Inflammation; Larynx; Models, Animal; Nerve Regeneration; Neurosurgical Procedures - instrumentation; Polyglycolic Acid; Polylactic acid; Primary repair; Prostheses and Implants; Rats, Wistar; Recurrent laryngeal nerve; Recurrent Laryngeal Nerve Injuries - surgery; Regeneration; Repair with conduit polyglycolic acid coated tube; Skin; Statistical analysis; Statistical methods; Surgery; Thyroid; Thyroid gland; Primary repair; Repair with conduit polyglycolic acid coated tube; Recurrent laryngeal nerve
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2019.06.015

Recurrent laryngeal nerve (RLN) injury is an important complication of thyroid surgery. In our study, we aimed to compare the effects of primary repair and polyglycolic acid (PGA) coated tube repair on nerve function and regeneration in RLN cuts in rats.
Twenty seven rats were used for the study. Group-1 with only nerve cuts, group-2 with primary repair, and group-3 with conduit repair. The study was planned over two-stage surgery. In the first step, nerve defect formation and nerve repair were performed in the same session. In the second step, samples were taken from the subjects for histopathological.
Vocal cord mobility was proportionally higher in group-3 than other groups. However, there was no statistically significant difference between the groups (p < 0.239). The mean number of highest axons were detected the group-3.
We think that PGA coated conduit can provide a more accurate orientation of nerve fibers by creating an isolated environment when compared to the primary repair. And this may be the cause of functional improvement in the nerve.
•Recurrent laryngeal nerve is known to be one of the most difficult nerves to reach functional regeneration after injury.•The use of vascularized nerve grafts, neural canals is extremely limited in the reconstruction of cranial nerves.•PGA coated tube was preferred in this study because of its ability to allow fibroblast proliferation.•PGA coated conduit can provide a more accurate orientation of nerve fibers by creating an isolated environment.