通过新辅助治疗恢复复发的喉神经功能:神经特征
Marika D Russell1, Amr H Abdelhamid Ahmed1, Zipei Feng2,3
1Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.
The Laryngoscope
|January 24, 2024
概括
新辅助疗法可以在晚期甲状腺癌中逆转复发性喉神经麻. 恢复的神经显示出正常的形态和功能,在大多数情况下允许手术保存.
科学领域:
- 甲状腺癌研究研究
- 新辅助疗法是一种新辅助疗法.
- 神经再生 神经再生
背景情况:
- 局部发达的甲状腺癌带来了治疗挑战,特别是在邻近的结构上,如复发性喉神经 (RLN).
- 新辅助向治疗是一种管理侵袭性甲状腺癌的新兴策略.
- 新辅助疗法对RLN功能和形态学的影响尚不清楚.
研究的目的:
- 描述在局部晚期甲状腺癌的新辅助治疗后恢复功能的RLN的形态和电生理特征.
- 评估影响RLN的癌性神经侵入的可逆性.
- 为了确定手术保存RLNs显示功能恢复的可行性.
主要方法:
- 对6名患有局部晚期甲状腺癌和RLN的受试者进行了多中心回顾性审查.
- 神经形态的分析 (A型与A型对比). B型),近位刺激 (正常,异常,缺席) 和手术管理 (切除与保存).
主要成果:
- 确定了6名单边声麻 (VFP) 的受试者,平均恢复时间为3个月.
- 所有恢复的神经都表现出A型形态 (仅涉及上腺).
- 在66.7%的病例中,近位刺激是正常的,在16.7%的病例中是异常的,在16.7%的病例中是没有的. 在83.3%的恢复神经中,手术保存是可能的.
结论:
- 这项研究提供了RLN在晚期甲状腺癌的新辅助治疗后恢复功能的第一个特征.
- 研究结果表明,RLN的癌性神经入侵可能是一个可逆的过程.
- 恢复后的RLN可以表现出正常的形态和电生理活动,支持神经保护策略.
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