title: Reflex laryngospasm induced by stimulation of distal esophageal afferents.
abstract: Distal esophageal sensory nerves were stimulated in 17 anesthetized dogs divided into three age groups to determine the laryngeal, cardiovascular, and respiratory effects. Group I puppies were 5 to 6 weeks of age, group II puppies were 8 to 19 weeks of age, and group III animals were adult dogs. Marked laryngeal adductor activity and laryngospasm were observed in group II puppies, while no or minimal laryngeal adduction was seen in younger puppies and adult dogs. Mean arterial pressure and heart rate increased significantly in groups II and III (P < .005) but remained unchanged in group I animals (P > .4). This response is distinctly different from the laryngeal chemoreflex because central apnea, hypotension, and bradycardia were absent. The afferent limb of the response is mediated by the vagus nerve as bilateral transthoracic truncal vagotomy eliminated the reflex. The laryngeal response observed following stimulation of distal esophageal afferent fibers may be important in the mechanism of apparent life-threatening events (ALTEs) and the sudden infant death syndrome (SIDS) associated with gastroesophageal reflux disease.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospital and Clinics, Iowa City 52242.
authors.forename: N M
authors.initials: NM
authors.lastname: Bauman
authors.forename: A D
authors.initials: AD
authors.lastname: Sandler
authors.forename: C
authors.initials: C
authors.lastname: Schmidt
authors.forename: J W
authors.initials: JW
authors.lastname: Maher
authors.forename: R J
authors.initials: RJ
authors.lastname: Smith
mesh_terms: D000344:Afferent Pathways / Q000502:physiology; D000375:Aging / Q000502:physiology*; D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D002211:Capsaicin / Q000494:pharmacology; D004285:Dogs; D004576:Electromyography; D004947:Esophagus / Q000294:innervation*; D005764:Gastroesophageal Reflux / Q000150:complications; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007223:Infant; D007826:Laryngismus / Q000209:etiology* / Q000503:physiopathology; D009475:Neurons, Afferent / Q000187:drug effects / Q000502:physiology*; D012018:Reflex / Q000502:physiology*; D013268:Stimulation, Chemical; D013398:Sudden Infant Death / Q000209:etiology; D015167:Vagotomy, Truncal; D014630:Vagus Nerve / Q000502:physiology
chemical_list: D002211:Capsaicin