Restoration of diaphragmatic function following vagophrenic anastomosis in the rat

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Abstract

Unilateral vagophrenic anastomosis or phrenicophrenic anastomosis was performed at the brachial plexus level. Five to 8 months later, the initially-paralyzed ipsilateral hemidiaphragm contracted normally in 5 of 8 vagophrenic rats and in all 6 phrenicophrenic controls. Transection of the vagus just below the nodose ganglion abolished the restored diaphragmatic contractions in the vagophrenic rats but not in the phrenicophrenic rats. Motor end-plates appeared normal histologically in both groups. In additional vagophrenic rats, inspiratory action potentials were recorded from the “phrenic” nerve, which now contained regenerated vagal fibers. These inspiratory volleys were unaffected by spinal cord transection above the phrenic motoneurons (C 1), but were abolished by cutting the vagus nerve rostral to the anastomosis. Inspiratory volleys were recorded from the vagus of unoperated rats proximal to the recurrent laryngeal branch and from the recurrent laryngeal nerve itself. No such volleys were found in the vagus nerve distal to the recurrent laryngeal branch. Therefore, recurrent laryngeal fibers of the vagus are presumed to be responsible for the observed return of diaphragmatic function after vagophrenic anastomosis; there is no need to postulate reorganization of intracentral neural pathways.

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