title: Tracheostomy abolishes paradoxical activation of the vocal cord adductor in multiple system atrophy.
abstract: OBJECTIVE
  Inspiratory activation of the vocal cord adductor, which causes paradoxical vocal cord motion, develops in patients with multiple system atrophy (MSA). To confirm the hypothesis that airway reflexes trigger such paradoxical activation, we investigated the effects of tracheostomy on the adductor activation in a MSA patient.
  
  
  METHODS
  We compared the adductor electromyograms before and after breathing was diverted to a tracheostoma under propofol anesthesia.
  
  
  RESULTS
  The adductor inspiratory activation disappeared during tracheostoma breathing.
  
  
  CONCLUSIONS
  Airway reflexes as well as MSA-related damage to the respiratory center contribute to the generation of paradoxical adductor activation in MSA patients.
authors.affiliation: Department of Otolaryngology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba City, Chiba 260-8670, Japan. shibak1963@yahoo.co.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Shiba
authors.forename: Shiroh
authors.initials: S
authors.lastname: Isono
mesh_terms: D004576:Electromyography; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D007821:Laryngeal Muscles / Q000503:physiopathology*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D012135:Respiratory Sounds / Q000209:etiology / Q000503:physiopathology*; D013018:Sound Spectrography; D014139:Tracheostomy; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D014827:Vocal Cords / Q000473:pathology / Q000503:physiopathology*