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Pathogenesis of laryngeal narrowing in patients with multiple system atrophy.
J Physiol. 2001 Oct 01; 536(Pt 1):237-49.JP

Abstract

1. We do not fully understand the pathogenesis of nocturnal laryngeal stridor in patients with multiple system atrophy (MSA). Recent studies suggest that inspiratory thyroarytenoid (TA) muscle activation has a role in the development of the stridor. 2. The breathing pattern and firing timing of TA muscle activation were determined in ten MSA patients, anaesthetized with propofol and breathing through the laryngeal mask airway, while the behaviour of the laryngeal aperture was being observed endoscopically. 3. Two distinct breathing patterns, i.e. no inspiratory flow limitation (no-IFL) and IFL, were identified during the measurements. During IFL, significant laryngeal narrowing was observed leading to an increase in laryngeal resistance and end-tidal carbon dioxide concentration. Development of IFL was significantly associated with the presence of phasic inspiratory activation of TA muscle. Application of continuous positive airway pressure suppressed the TA muscle activation. 4. The results indicate that contraction of laryngeal adductors during inspiration narrows the larynx leading to development of inspiratory flow limitation accompanied by stridor in patients with MSA under general anaesthesia.

Authors+Show Affiliations

Department of Anaesthesiology, Chiba University School of Medicine, 1-8-1 Inohana-cho, Chuo-ku, Chiba, 260-8670, Japan. isonos@ho.chiba-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

11579172

Citation

Isono, S, et al. "Pathogenesis of Laryngeal Narrowing in Patients With Multiple System Atrophy." The Journal of Physiology, vol. 536, no. Pt 1, 2001, pp. 237-49.
Isono S, Shiba K, Yamaguchi M, et al. Pathogenesis of laryngeal narrowing in patients with multiple system atrophy. J Physiol (Lond). 2001;536(Pt 1):237-49.
Isono, S., Shiba, K., Yamaguchi, M., Tanaka, A., Hattori, T., Konno, A., & Nishino, T. (2001). Pathogenesis of laryngeal narrowing in patients with multiple system atrophy. The Journal of Physiology, 536(Pt 1), 237-49.
Isono S, et al. Pathogenesis of Laryngeal Narrowing in Patients With Multiple System Atrophy. J Physiol (Lond). 2001 Oct 1;536(Pt 1):237-49. PubMed PMID: 11579172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathogenesis of laryngeal narrowing in patients with multiple system atrophy. AU - Isono,S, AU - Shiba,K, AU - Yamaguchi,M, AU - Tanaka,A, AU - Hattori,T, AU - Konno,A, AU - Nishino,T, PY - 2001/10/2/pubmed PY - 2002/1/5/medline PY - 2001/10/2/entrez SP - 237 EP - 49 JF - The Journal of physiology JO - J. Physiol. (Lond.) VL - 536 IS - Pt 1 N2 - 1. We do not fully understand the pathogenesis of nocturnal laryngeal stridor in patients with multiple system atrophy (MSA). Recent studies suggest that inspiratory thyroarytenoid (TA) muscle activation has a role in the development of the stridor. 2. The breathing pattern and firing timing of TA muscle activation were determined in ten MSA patients, anaesthetized with propofol and breathing through the laryngeal mask airway, while the behaviour of the laryngeal aperture was being observed endoscopically. 3. Two distinct breathing patterns, i.e. no inspiratory flow limitation (no-IFL) and IFL, were identified during the measurements. During IFL, significant laryngeal narrowing was observed leading to an increase in laryngeal resistance and end-tidal carbon dioxide concentration. Development of IFL was significantly associated with the presence of phasic inspiratory activation of TA muscle. Application of continuous positive airway pressure suppressed the TA muscle activation. 4. The results indicate that contraction of laryngeal adductors during inspiration narrows the larynx leading to development of inspiratory flow limitation accompanied by stridor in patients with MSA under general anaesthesia. SN - 0022-3751 UR - https://www.unboundmedicine.com/medline/citation/11579172/Pathogenesis_of_laryngeal_narrowing_in_patients_with_multiple_system_atrophy_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0022-3751&date=2001&volume=536&spage=237 DB - PRIME DP - Unbound Medicine ER -