Laryngeal adductory pressure as a measure of post-reinnervation synkinesis.
Laryngeal adductory pressure (LAP) is the pressure induced as the vocal folds squeeze on a balloon while the recurrent laryngeal nerve (RLN) is stimulated. The LAP has been shown to vary with the frequency of stimulation, with a characteristic slope. The RLN was divided and reanastomosed 4 different ways in 12 canine hemilaryngeal preparations; the 4 subgroups represented a range of expected post-reinnervation synkinesis recovery patterns. The LAP frequency-response curve was measured before surgery and at monthly intervals for 6 months after surgery. In the "best-case" group (RLN adductor and abductor trunks each divided and reanastomosed), the slope was found to return to normal. The 2 whole RLN division-reanastomosis groups (precise realignment or 180 degrees rotation) both gave results similar to those of the "worst-case" group (RLN adductor and abductor trunks divided and transposed); these 3 subgroups were all significantly different from baseline. The slope of the LAP frequency-response curve may be a useful means of indirectly quantifying laryngeal synkinesis.
Paniello
R C
RC
Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, and the Department of Veterans Affairs Medical Center, St Louis, Missouri 63110, USA.
West
S E
SE
D000818:Animals; D004285:Dogs; D007821:Laryngeal Muscles / Q000294:innervation*; D009121:Muscle Denervation; D011312:Pressure; D012009:Recurrent Laryngeal Nerve / Q000502:physiology*; D014827:Vocal Cords / Q000294:innervation*