Three-dimensional changes in the upper airway during neuromuscular stimulation of laryngeal muscles.
During swallowing, airway protection depends upon adequate glottal closure and laryngeal elevation to prevent the entry of substances into the airway. Three-dimensional changes in the upper airway during laryngeal muscle stimulation in a canine model were quantified in animals implanted with Peterson type stimulating electrodes in the inferior and superior portions of the thyroarytenoid muscle, together with a reference electrode. Computer tomography scanning was performed on an IMATRON scanner with a 3 mm slice thickness advanced at overlapping 1 mm increments. Stimulation of the thyroarytenoid muscle produced adductions of the vocal fold towards the midline and changes in the supraglottic region as well as the glottis; the glottic wall was compressed medially above and below the glottis. These results suggest that chronic neuromuscular stimulation can effect glottic protection by reducing the glottal opening and may be beneficial for patients with central control disorders affecting airway protection during swallowing.
Ludlow
C L
CL
Voice and Speech Section, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland 20892-1416, USA. ludlowc@nidcd.nih.gov
Hang
C
C
Bielamowicz
S
S
Choyke
P
P
Hampshire
V
V
Selbie
W S
WS
D000818:Animals; D016477:Artifacts; D003679:Deglutition / Q000502:physiology; D004195:Disease Models, Animal; D004285:Dogs; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D005931:Glottis / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000502:physiology; D007091:Image Processing, Computer-Assisted; D007821:Laryngeal Muscles / Q000294:innervation / Q000502:physiology*; D007830:Larynx / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D009469:Neuromuscular Junction / Q000502:physiology; D014057:Tomography, X-Ray Computed; D014827:Vocal Cords / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000502:physiology