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Inspiratory activation of the vocal cord adductor, part I: human study in patients with restricted abduction of the vocal cords.
Laryngoscope. 2004 Feb; 114(2):372-5.L

Abstract

OBJECTIVES/HYPOTHESIS

In patients with restricted abduction of the vocal cords, it has generally been accepted that glottis narrowing with laryngeal stridor during inspiration is attributed to static and passive obstruction of the glottis. However, active glottis narrowing can also be contributory. We tested the hypothesis that the vocal cord adductor is activated during inspiration in patients with restricted abduction of the vocal cords.

STUDY DESIGN

Electromyographic evaluation of vocal cord adductor activity in patients with restricted abduction of the vocal cords.

METHODS

Five patients with restricted abduction of the vocal cords who had stridor with mild to severe dyspnea during wakefulness were anesthetized with propofol. We recorded the adductor muscle electromyogram during breathing through a laryngeal mask airway while observing the vocal cord movement endoscopically. In three patients who had undergone tracheostomy, we also recorded adductor firing patterns not only while closing but also while opening the tracheostoma.

RESULTS

The adductor was activated during inspiration, and the glottis was narrowed in accordance with inspiratory stridor. This adductor inspiratory activity was abolished by opening the tracheostoma in the tracheostomized patients.

CONCLUSION

Not only static or passive glottis narrowing but also active narrowing may contribute to inspiratory flow limitation in patients with restricted abduction of the vocal cords. This active glottis narrowing is probably induced by an airway reflex.

Authors+Show Affiliations

Department of Otolaryngology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba 260-8670, Japan. shiba@med.m.chiba-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14755221

Citation

Shiba, Keisuke, et al. "Inspiratory Activation of the Vocal Cord Adductor, Part I: Human Study in Patients With Restricted Abduction of the Vocal Cords." The Laryngoscope, vol. 114, no. 2, 2004, pp. 372-5.
Shiba K, Isono S, Sekita Y, et al. Inspiratory activation of the vocal cord adductor, part I: human study in patients with restricted abduction of the vocal cords. Laryngoscope. 2004;114(2):372-5.
Shiba, K., Isono, S., Sekita, Y., & Tanaka, A. (2004). Inspiratory activation of the vocal cord adductor, part I: human study in patients with restricted abduction of the vocal cords. The Laryngoscope, 114(2), 372-5.
Shiba K, et al. Inspiratory Activation of the Vocal Cord Adductor, Part I: Human Study in Patients With Restricted Abduction of the Vocal Cords. Laryngoscope. 2004;114(2):372-5. PubMed PMID: 14755221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inspiratory activation of the vocal cord adductor, part I: human study in patients with restricted abduction of the vocal cords. AU - Shiba,Keisuke, AU - Isono,Shiroh, AU - Sekita,Yasuko, AU - Tanaka,Atsuko, PY - 2004/2/3/pubmed PY - 2004/3/10/medline PY - 2004/2/3/entrez SP - 372 EP - 5 JF - The Laryngoscope JO - Laryngoscope VL - 114 IS - 2 N2 - OBJECTIVES/HYPOTHESIS: In patients with restricted abduction of the vocal cords, it has generally been accepted that glottis narrowing with laryngeal stridor during inspiration is attributed to static and passive obstruction of the glottis. However, active glottis narrowing can also be contributory. We tested the hypothesis that the vocal cord adductor is activated during inspiration in patients with restricted abduction of the vocal cords. STUDY DESIGN: Electromyographic evaluation of vocal cord adductor activity in patients with restricted abduction of the vocal cords. METHODS: Five patients with restricted abduction of the vocal cords who had stridor with mild to severe dyspnea during wakefulness were anesthetized with propofol. We recorded the adductor muscle electromyogram during breathing through a laryngeal mask airway while observing the vocal cord movement endoscopically. In three patients who had undergone tracheostomy, we also recorded adductor firing patterns not only while closing but also while opening the tracheostoma. RESULTS: The adductor was activated during inspiration, and the glottis was narrowed in accordance with inspiratory stridor. This adductor inspiratory activity was abolished by opening the tracheostoma in the tracheostomized patients. CONCLUSION: Not only static or passive glottis narrowing but also active narrowing may contribute to inspiratory flow limitation in patients with restricted abduction of the vocal cords. This active glottis narrowing is probably induced by an airway reflex. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/14755221/Inspiratory_activation_of_the_vocal_cord_adductor_part_I:_human_study_in_patients_with_restricted_abduction_of_the_vocal_cords_ L2 - https://doi.org/10.1097/00005537-200402000-00036 DB - PRIME DP - Unbound Medicine ER -