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Christy L. Ludlow - One of the best experts on this subject based on the ideXlab platform.
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suppression of Thyroarytenoid Muscle responses during repeated air pressure stimulation of the laryngeal mucosa in awake humans
Annals of Otology Rhinology and Laryngology, 2005Co-Authors: Pamela R Kearney, Eric A Mann, Christopher Poletto, Christy L. LudlowAbstract:Repeated stimulation of the laryngeal mucosa occurs during speech. Single stimuli, however, can elicit the laryngeal adductor response (LAR). Our hypothesis was that the LAR to repeated rapid air pressure stimuli is centrally suppressed in humans. Hooked-wire electrodes were inserted into the Thyroarytenoid and cricothyroid Muscles on both sides and into the posterior cricoarytenoid Muscle on one side. Pairs of air puff stimuli were presented to the mucosa over the arytenoids at pressure levels three times threshold with interstimulus intervals from 250 to 5,000 ms. Bilateral Thyroarytenoid responses occurred at around 150 ms to more than 70% of the initial stimuli. With repeated presentation at intervals of 2 seconds or less, the percent occurrence decreased to less than 40% and response amplitudes were reduced by 50%. Central suppression of adductor responses to repeated air puff stimuli may allow speakers to produce voice without eliciting reflexive spasms that could disrupt speech.
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Thyroarytenoid Muscle responses to air pressure stimulation of the laryngeal mucosa in humans
Annals of Otology Rhinology and Laryngology, 2003Co-Authors: Priyanka Bhabu, Steven Bielamowicz, Christopher Poletto, Eric A Mann, Christy L. LudlowAbstract:Others have observed glottic adduction in response to air puff stimuli and suggested that this is a reliable indicator of laryngeal sensation. We undertook to determine whether the same thresholds are found if one uses either Thyroarytenoid (TA) Muscle responses or subjects' reports of laryngeal sensation. We also studied the characteristics of TA responses to unilateral air pressure stimulation of the mucosa overlying the arytenoid cartilages. Ten normal volunteers provided button press responses to air pressure stimuli during bilateral TA electromyography. Similar thresholds were determined by reports of sensation as by electromyographic responses (p < .0005). The early TA responses occurred either around 80 ms or around 125 ms after onset of the air puff, with equal frequency on the ipsilateral and contralateral sides. The TA Muscle responses to air pressure stimulation differ in physiological characteristics from the laryngeal adductor reflex that occurs in response to electrical stimulation of the superior laryngeal nerve.
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adductor Muscle activity abnormalities in abductor spasmodic dysphonia
Otolaryngology-Head and Neck Surgery, 2001Co-Authors: Carlos B Cyrus, Steven Bielamowicz, Frank Evans, Christy L. LudlowAbstract:Abstract Objective: To determine laryngeal Muscle activation abnormalities associated with speech symptoms in abductor spasmodic dysphonia (ABSD). Study Design: Bilateral laryngeal Muscle recordings from the posterior cricoarytenoid, Thyroarytenoid, and cricothyroid Muscles were conducted in 12 ABSD patients. Patients' measures were compared during speech breaks and during speech without breaks and with 10 normal controls. Results: Significant group differences were found in the Thyroarytenoid Muscle; the patients had significantly greater activity on the right side both during speech breaks and nonbreaks in comparison with the controls. Cricothyroid Muscle levels were also increased on the right in the patients. Conclusion: An asymmetry in adductor Muscle tone between the 2 sides in ABSD may account for difficulties with maintaining phonation and voice onset after voiceless consonants. Significance: These abnormalities may indicate why PCA BOTOX injections have not been as effective in ABSD as Thyroarytenoid injections have been in adductor spasmodic dysphonia. (Otolaryngol Head Neck Surg 2001;124:23-30)
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effects of botulinum toxin on pathophysiology in spasmodic dysphonia
Annals of Otology Rhinology and Laryngology, 2000Co-Authors: Steven Bielamowicz, Christy L. LudlowAbstract:To determine the mechanism of symptom relief with treatment by botulinum toxin injection in persons with adductor spasmodic dysphonia (ADSD), we evaluated the effects of unilateral Thyroarytenoid Muscle injections on both injected and noninjected Muscles in 10 subjects with ADSD, using electromyography on both sides of the larynx before and after treatment. The subjects' speech symptoms were reduced (p = .005) 2 weeks following injection, when the electromyographic study occurred. Muscle activation levels and the numbers of spasmodic Muscle bursts decreased significantly (p or = .7) in all Muscles. Reductions in laryngeal Muscle bursts did not relate to either absolute or normalized levels of Muscle activity before or after botulinum toxin injection. The results suggest that changes in the central pathophysiology are responsible for changes in speech symptoms following treatment.
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effects of botulinum toxin on pathophysiology in spasmodic dysphonia
Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, 2000Co-Authors: Steven Bielamowicz, Christy L. LudlowAbstract:To determine the mechanism of symptom relief with treatment by botulinum toxin injection in persons with adductor spasmodic dysphonia (ADSD), we evaluated the effects of unilateral Thyroarytenoid Muscle injections on both injected and noninjected Muscles in 10 subjects with ADSD, using electromyography on both sides of the larynx before and after treatment. The subjects' speech symptoms were reduced (p = .005) 2 weeks following injection, when the electromyographic study occurred. Muscle activation levels and the numbers of spasmodic Muscle bursts decreased significantly (p ≤.03) postinjection in both the injected and noninjected Muscles. The reductions in laryngeal Muscle bursts correlated with symptom reduction (r ≥.7) in all Muscles. Reductions in laryngeal Muscle bursts did not relate to either absolute or normalized levels of Muscle activity before or after botulinum toxin injection. The results suggest that changes in the central pathophysiology are responsible for changes in speech symptoms following treatment.
Eiji Yumoto - One of the best experts on this subject based on the ideXlab platform.
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modulation of satellite cells activity and myod in rat Thyroarytenoid Muscle after reinnervation
Laryngoscope, 2015Co-Authors: Haruka Kodama, Yoshihiko Kumai, Tetsuji Sanuki, Kohei Nishimoto, Eiji YumotoAbstract:Objectives/Hypothesis To examine modulation of M-cadherin, a marker for satellite cells (SCs); and MyoD, which may indicate the myogenic activity following recurrent laryngeal nerve (RLN) denervation and immediate reinnervation; and to elucidate the correlation between their modulations and establishment of neuromuscular junctions (NMJs) in the reinnervated rat Thyroarytenoid (TA) Muscle. Study Design Quantitative real-time polymerase chain reaction qPCR and histologic assessment of the TA Muscle following RLN transection and anastomosis. Methods Rats were divided into three groups: 1) denervation alone (DNV) (n = 60), 2) denervation with anastomosis (ANS) (n = 60), and 3) sham-operated controls (n = 12). Animals were sacrificed at 3 days and 1, 3, and 5 weeks after treatment. TA Muscles harvested from 40 animals from each DNV and ANS group; all of sham group were subjected to qPCR for assessment of the modulation of M-cadherin and MyoD; and the remaining larynges of DNV and ANS group were used for histologic analysis. Results The expression levels of messenger RNAs (mRNAs) encoding M-cadherin and MyoD in the TA Muscle of the DNV group were significantly higher (P < 0.05) than in the control throughout the study period. These mRNA levels in the ANS group were significantly higher (P < 0.05) at ≤ 1 week than in the controls but fell to control levels at ≥ 3 weeks. In the ANS group, recovery of Muscle area and NMJs structure occurred by 3 weeks. Conclusion These data suggested that NMJ formation following reinnervation might prompt recovery of M-cadherin and MyoD mRNA expression to the quiescent level of SCs. Level of Evidence N/A. Laryngoscope, 125:E245–E251, 2015
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Research Article The Role of Immediate Recurrent Laryngeal Nerve Reconstruction for Thyroid Cancer Surgery
2013Co-Authors: Tetsuji Sanuki, Eiji Yumoto, Ryosei Minoda, Narihiro KodamaAbstract:Copyright © 2010 Tetsuji Sanuki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Unilateral vocal fold paralysis (UVFP) is one of the most serious problems in conducting surgery for thyroid cancer. Different treatments are available for the management of UVFP including intracordal injection, type I thyroplasty, arytenoid adduction, and laryngeal reinnervations. The effects of immediate recurrent laryngeal nerve (RLN) reconstruction during thyroid cancer surgery with or without UVFP before the surgery were evaluated with videostroboscopic, aerodynamic, and perceptual analyses. All subjects experienced postoperative improvements in voice quality. Particularly, aerodynamic analysis showed that the values for all patients entered normal ranges in both patients with and without UVFP before surgery. Immediate RLN reconstruction has the potential to restore a normal or near-normal voice by returning Thyroarytenoid Muscle tone and bulk seen with vocal fold denervation. Immediate RLN reconstruction is an efficient and effective approach to the management of RLN resection during surgery for thyroid cancer. 1
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nerve Muscle pedicle flap implantation combined with arytenoid adduction
Archives of Otolaryngology-head & Neck Surgery, 2010Co-Authors: Eiji Yumoto, Tetsuji Sanuki, Yutaka Toya, Narihiro Kodama, Yoshihiko KumaiAbstract:Objectives To describe a new technique of nerve-Muscle pedicle (NMP) flap implantation combined with arytenoid adduction (AA) to treat dysphonia due to unilateral vocal fold paralysis and to examine postoperative vocal function. Study Design Retrospective review of clinical records. Setting Tertiary academic center. Patients Twenty-two consecutive patients underwent NMP flap implantation with AA and were followed up short term over a period of 1 to 6 months (mean, 2.9 months) and long term over a period of 7 to 36 months (mean, 21.4 months). Interventions An NMP flap was made using an ansa cervicalis branch and a piece of the sternohyoid Muscle. A window was opened in the thyroid ala at the level of the vocal fold. Then, AA was performed and the NMP flap was securely implanted onto the Thyroarytenoid Muscle through the window under microscopic guidance. Main Outcome Measures The maximum phonation time, mean airflow rate, pitch range, and acoustic parameters (jitter, shimmer, and harmonics to noise ratio) were evaluated before surgery and twice after surgery. Results All parameters improved significantly after surgery ( P P P Conclusions Precise harvest of an NMP flap and its placement directly onto the Thyroarytenoid Muscle combined with AA provided excellent vocal function. The NMP method may have played a certain role in the improvement of postoperative vocal function, although further study with electromyographic examination is required to clarify the innervation status of the Thyroarytenoid Muscle.
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nerve Muscle pedicle implantation facilitates re innervation of long term denervated Thyroarytenoid Muscle in rats
Acta Oto-laryngologica, 2009Co-Authors: Satoru Miyamaru, Yoshihiko Kumai, Tetsuji Sanuki, Takaaki Ito, Eiji YumotoAbstract:Conclusions: Nerve-Muscle pedicle (NMP) implantation was effective in the recovery from atrophic changes in long-term denervated Thyroarytenoid (TA) Muscle. Re-innervation occurred via the transferred nerve. However, the effectiveness of the NMP method may decline with increasing duration of denervation. Objectives: To evaluate the effects of NMP implantation on long-term denervated rat TA Muscle. Materials and methods: Wistar rats (n=105) were divided into two groups in which the left recurrent laryngeal nerve (RLN) was transected without (DNV group) or with (NMP group) subsequent NMP implantation, and subgroups of each group were formed depending on the period after RLN transection (immediate to 48 weeks). In the DNV subgroups, we histologically assessed the area of Muscle and the number of neuromuscular junctions. In the NMP subgroups, we performed electromyographic, videolaryngoscopic, and histologic assessments. The Muscle area and Muscle action potentials were evaluated by comparing the treated and ...
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quantitative evaluation of the effects of Thyroarytenoid Muscle activity upon pliability of vocal fold mucosa in an in vivo canine model
Laryngoscope, 1997Co-Authors: Eiji Yumoto, Yoshimi KadotaAbstract:Stiffness of the vocal fold is a significant factor in determining mucosal wave propagation and in the control of the fundamental frequency of phonation. We measured pliability of the vocal fold mucosa in an in vivo canine model as an index of stiffness while the histological layer-by-layer structure of the vocal fold was not disrupted. The point 1 mm below the free edge showed a maximal pliability that gradually diminished toward the tracheal side and reached a minimum. When the Thyroarytenoid (TA) Muscle contracted, pliability of the mucosa was significantly increased (P < 0.001). Mucosal pliability of the excised larynx was significantly increased compared with that in vivo (P < 0.001). The point of minimal pliability in the absence of TA Muscle contraction did not shift after excision of the larynx, while TA Muscle contraction caused a downward shift of the point of minimal pliability. Mucosal pliability can thus be used to quantitatively assess the effects of TA Muscle contraction on stiffness of the vocal fold mucosa.
Hugh D. Curtin - One of the best experts on this subject based on the ideXlab platform.
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Atrophy of the Posterior Cricoarytenoid Muscle as an Indicator of Recurrent Laryngeal Nerve Palsy
2015Co-Authors: Laura Vitale Romo, Hugh D. CurtinAbstract:BACKGROUND AND PURPOSE: The posterior cricoarytenoid (PCA) Muscle is one of the intrinsic Muscles of the larynx innervated by the recurrent laryngeal nerve. As such, recurrent laryngeal nerve palsy should not only result in paralysis of the true vocal cord or thyroary-tenoid Muscle but also in a similar change in the PCA Muscle. The ability of CT and MR imaging to depict denervation atrophy in the PCA Muscle in patients with recurrent laryngeal nerve palsy was evaluated. METHODS: Two investigators reviewed the CT and/or MR studies of 20 patients with a clinical history of vocal cord paralysis. The appearance of the PCA Muscle was given a rating of 0, 1, 2, 3, or 4, with 0 being definitely normal and 4 being definitely abnormal or atrophic. Each study was also reviewed for the presence or absence of other features of vocal cord paralysis: Thyroarytenoid Muscle atrophy, anteromedial deviation of the arytenoid cartilage, an enlarged piriform sinus and laryngeal ventricle, and a paramedian cord. RESULTS: Atrophy of the PCA Muscle was shown unequivocally in 65 % of the cases and was most likely present in an additional 20%. The frequency with which other features of vocal cord paralysis were seen was as follows: Thyroarytenoid atrophy, 95%; anteromedial deviatio
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Atrophy of the Posterior Cricoarytenoid Muscle as an Indicator of Recurrent Laryngeal Nerve Palsy
AJNR. American journal of neuroradiology, 1999Co-Authors: Laura Vitale Romo, Hugh D. CurtinAbstract:BACKGROUND AND PURPOSE: The posterior cricoarytenoid (PCA) Muscle is one of the intrinsic Muscles of the larynx innervated by the recurrent laryngeal nerve. As such, recurrent laryngeal nerve palsy should not only result in paralysis of the true vocal cord or Thyroarytenoid Muscle but also in a similar change in the PCA Muscle. The ability of CT and MR imaging to depict denervation atrophy in the PCA Muscle in patients with recurrent laryngeal nerve palsy was evaluated. METHODS: Two investigators reviewed the CT and/or MR studies of 20 patients with a clinical history of vocal cord paralysis. The appearance of the PCA Muscle was given a rating of 0, 1, 2, 3, or 4, with 0 being definitely normal and 4 being definitely abnormal or atrophic. Each study was also reviewed for the presence or absence of other features of vocal cord paralysis: Thyroarytenoid Muscle atrophy, anteromedial deviation of the arytenoid cartilage, an enlarged piriform sinus and laryngeal ventricle, and a paramedian cord. RESULTS: Atrophy of the PCA Muscle was shown unequivocally in 65% of the cases and was most likely present in an additional 20%. The frequency with which other features of vocal cord paralysis were seen was as follows: Thyroarytenoid atrophy, 95%; anteromedial deviation of the arytenoid cartilage, 70%; enlarged piriform sinus, 100%; enlarged laryngeal ventricle, 90%; and a paramedian cord, 100%. CONCLUSION: Atrophy of the PCA Muscle may be commonly documented on CT and MR studies in patients with recurrent laryngeal nerve palsy and vocal cord paralysis, and therefore should be part of the constellation of imaging features of vocal cord paralysis. This finding is particularly useful when other imaging findings of vocal cord paralysis are absent or equivocal.
Norman D. Hogikyan - One of the best experts on this subject based on the ideXlab platform.
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Ann Otol Rhinol Laryn!io/llO:2001 MOTION-SPECIFIC LARYNGEAL REINNERVATION USING Muscle-NERVE-Muscle NEUROTIZATION
2016Co-Authors: Norman D. Hogikyan, Michael M. Johns, William R CarrollAbstract:There is no current treatment method that can reliably restore physiologic movement to a paralyzed vocal fold. The purposes of this study were to test the hypotheses that I) Muscle-nerve-Muscle (M-N-M) neurotization can be induced in feline laryngeal Muscles and 2) M-N-M neurotization can restore movement to a paralyzed vocal fold. Muscle-nerve-Muscle neurotization can be defined as the reinnervation of a denervated Muscle via axons that are induced to sprout from nerves within an innervated Muscle and that then traverse a nerve graft interposed between it and the target denervated Muscle. A paralyzed laryngeal Muscle could be reinnervated by axons from its contralateral paired Muscle, thus achieving motion-specific reinnervation. Eighteen adult cats were divided into sham, hemilaryngeal-denervated, and M-N-M-reinnervated Thyroarytenoid Muscle groups. Five of the 6 reinnervated animals had histo-logic evidence ofaxons in the nerve graft, 4 of the 6 had evoked electromyographic evidence of crossed reinnervation, and I of the 6 had a return of appropriately phased adduction. This technique has great potential and should be further investigated. KEY WORDS- cat, laryngeal reinnervation, larynx, Muscle-nerve-Muscle neurotization, vocal fold paralysis
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Spontaneous laryngeal reinnervation following chronic recurrent laryngeal nerve injury
Laryngoscope, 2013Co-Authors: Robbi A. Kupfer, Sang Su Oh, Eva L. Feldman, Norman D. HogikyanAbstract:Objectives/Hypothesis To enhance understanding of spontaneous laryngeal Muscle reinnervation following severe recurrent laryngeal nerve injury by testing the hypotheses that 1) nerve fibers responsible for Thyroarytenoid Muscle reinnervation can originate from multiple sources and 2) superior laryngeal nerve is a source of reinnervation. Study Design Prospective, controlled, animal model. Methods A combination of retrograde neuronal labeling techniques, immunohistochemistry, electromyography, and sequential observations of vocal fold mobility were employed in rat model of chronic recurrent laryngeal nerve injury. The current study details an initial set of experiments in sham surgical and denervated group animals and a subsequent set of experiments in a denervated group. Results At 3 months after recurrent laryngeal nerve resection, retrograde brainstem neuronal labeling identified cells in the characteristic superior laryngeal nerve cell body location as well as cells in a novel caudal location. Regrowth of neuron fibers across the site of previous recurrent laryngeal nerve resection was seen in 87% of examined animals in the denervated group. Electromyographic data support innervation by both the superior and recurrent laryngeal nerves following chronic recurrent laryngeal nerve injury. Conclusions Following chronic recurrent laryngeal nerve injury in the rat, laryngeal innervation is demonstrated through the superior laryngeal nerve from cells both within and outside of the normal cluster of cells that supply the superior laryngeal nerve. The recurrent laryngeal nerve regenerates across a surgically created gap, but functional significance of regenerated nerve fibers is unclear. Laryngoscope, 123:2216–2227, 2013
Steven Bielamowicz - One of the best experts on this subject based on the ideXlab platform.
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Thyroarytenoid Muscle responses to air pressure stimulation of the laryngeal mucosa in humans
Annals of Otology Rhinology and Laryngology, 2003Co-Authors: Priyanka Bhabu, Steven Bielamowicz, Christopher Poletto, Eric A Mann, Christy L. LudlowAbstract:Others have observed glottic adduction in response to air puff stimuli and suggested that this is a reliable indicator of laryngeal sensation. We undertook to determine whether the same thresholds are found if one uses either Thyroarytenoid (TA) Muscle responses or subjects' reports of laryngeal sensation. We also studied the characteristics of TA responses to unilateral air pressure stimulation of the mucosa overlying the arytenoid cartilages. Ten normal volunteers provided button press responses to air pressure stimuli during bilateral TA electromyography. Similar thresholds were determined by reports of sensation as by electromyographic responses (p < .0005). The early TA responses occurred either around 80 ms or around 125 ms after onset of the air puff, with equal frequency on the ipsilateral and contralateral sides. The TA Muscle responses to air pressure stimulation differ in physiological characteristics from the laryngeal adductor reflex that occurs in response to electrical stimulation of the superior laryngeal nerve.
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adductor Muscle activity abnormalities in abductor spasmodic dysphonia
Otolaryngology-Head and Neck Surgery, 2001Co-Authors: Carlos B Cyrus, Steven Bielamowicz, Frank Evans, Christy L. LudlowAbstract:Abstract Objective: To determine laryngeal Muscle activation abnormalities associated with speech symptoms in abductor spasmodic dysphonia (ABSD). Study Design: Bilateral laryngeal Muscle recordings from the posterior cricoarytenoid, Thyroarytenoid, and cricothyroid Muscles were conducted in 12 ABSD patients. Patients' measures were compared during speech breaks and during speech without breaks and with 10 normal controls. Results: Significant group differences were found in the Thyroarytenoid Muscle; the patients had significantly greater activity on the right side both during speech breaks and nonbreaks in comparison with the controls. Cricothyroid Muscle levels were also increased on the right in the patients. Conclusion: An asymmetry in adductor Muscle tone between the 2 sides in ABSD may account for difficulties with maintaining phonation and voice onset after voiceless consonants. Significance: These abnormalities may indicate why PCA BOTOX injections have not been as effective in ABSD as Thyroarytenoid injections have been in adductor spasmodic dysphonia. (Otolaryngol Head Neck Surg 2001;124:23-30)
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effects of botulinum toxin on pathophysiology in spasmodic dysphonia
Annals of Otology Rhinology and Laryngology, 2000Co-Authors: Steven Bielamowicz, Christy L. LudlowAbstract:To determine the mechanism of symptom relief with treatment by botulinum toxin injection in persons with adductor spasmodic dysphonia (ADSD), we evaluated the effects of unilateral Thyroarytenoid Muscle injections on both injected and noninjected Muscles in 10 subjects with ADSD, using electromyography on both sides of the larynx before and after treatment. The subjects' speech symptoms were reduced (p = .005) 2 weeks following injection, when the electromyographic study occurred. Muscle activation levels and the numbers of spasmodic Muscle bursts decreased significantly (p or = .7) in all Muscles. Reductions in laryngeal Muscle bursts did not relate to either absolute or normalized levels of Muscle activity before or after botulinum toxin injection. The results suggest that changes in the central pathophysiology are responsible for changes in speech symptoms following treatment.
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effects of botulinum toxin on pathophysiology in spasmodic dysphonia
Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, 2000Co-Authors: Steven Bielamowicz, Christy L. LudlowAbstract:To determine the mechanism of symptom relief with treatment by botulinum toxin injection in persons with adductor spasmodic dysphonia (ADSD), we evaluated the effects of unilateral Thyroarytenoid Muscle injections on both injected and noninjected Muscles in 10 subjects with ADSD, using electromyography on both sides of the larynx before and after treatment. The subjects' speech symptoms were reduced (p = .005) 2 weeks following injection, when the electromyographic study occurred. Muscle activation levels and the numbers of spasmodic Muscle bursts decreased significantly (p ≤.03) postinjection in both the injected and noninjected Muscles. The reductions in laryngeal Muscle bursts correlated with symptom reduction (r ≥.7) in all Muscles. Reductions in laryngeal Muscle bursts did not relate to either absolute or normalized levels of Muscle activity before or after botulinum toxin injection. The results suggest that changes in the central pathophysiology are responsible for changes in speech symptoms following treatment.
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Three-dimensional changes in the upper airway during neuromuscular stimulation of laryngeal Muscles.
Artificial organs, 1999Co-Authors: Christy L. Ludlow, Steven Bielamowicz, Cynthia Hang, Peter Choyke, Victoria Hampshire, W. Scott SelbieAbstract: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.