Comparison of the Glottic Closure Reflex in Traditional “Open” Versus Endoscopic Laser Supraglottic Laryngectomy

2007 ◽  
Vol 2007 ◽  
pp. 149-150
Author(s):  
M.A. Keefe
Keyword(s):  
Supraglottic Laryngectomy ◽  
Glottic Closure ◽  
Endoscopic Laser ◽  
Open Versus ◽  
Glottic Closure Reflex

Effects of Altered Consciousness on the Protective Glottic Closure Reflex

2006 ◽  
Vol 115 (10) ◽  
pp. 759-763 ◽  
Author(s):  
Clarence T. Sasaki ◽  
Ziwei Yu ◽  
Jiajun Xu ◽  
Jagdeep Hundal ◽  
William Rosenblatt
Keyword(s):  
Altered Consciousness ◽  
Glottic Closure ◽  
Glottic Closure Reflex

Critical Role of Central Facilitation in the Glottic Closure Reflex

2001 ◽  
Vol 110 (5) ◽  
pp. 401-405 ◽  
Author(s):  
Clarence T. Sasaki ◽  
Steven Ho ◽  
Young-Ho Kim
Keyword(s):  
Critical Role ◽  
Glottic Closure ◽  
Glottic Closure Reflex

Initiation of Reflex Glottic Closure

1976 ◽  
Vol 85 (3) ◽  
pp. 382-386 ◽  
Author(s):  
Masafumi Suzuki ◽  
Clarence T. Sasaki
Keyword(s):  
Single Unit ◽  
Laryngeal Nerve ◽  
Surgical Trauma ◽  
Review Of The Literature ◽  
Relative Ease ◽  
Glottic Closure ◽  
Tumor Involvement ◽  
Weak Stimulus ◽  
Adult Cat ◽  
Glottic Closure Reflex

Review of the literature reveals scant information regarding the initiation of reflex glottic closure. Using the adult cat as our experimental model, we have attempted to analyze both the ipsilateral and crossed laryngeal adductor responses involved in reflex closure of the glottis. These ipsilateral and crossed reflexes are particularly well developed in the cat allowing their study with relative ease. From multifiber and single unit recurrent laryngeal nerve preparations, detailed descriptions of both peripheral and central neural organizations of these reflexes may be obtained. These data further elucidate the mechanism for initial incoordination of the glottic closure reflex, resulting from weak stimulus applied simultaneously to both superior laryngeal nerves, or from unilateral superior laryngeal denervation due to surgical trauma, metabolic neuropathy, or direct tumor involvement.

scholarly journals Characteristics of Glottic Closure Reflex in a Canine Model

2009 ◽  
Vol 50 (3) ◽  
pp. 380 ◽  
Author(s):  
Young-Ho Kim ◽  
Ju Wan Kang ◽  
Kwang-Moon Kim
Keyword(s):  
Canine Model ◽  
Glottic Closure ◽  
Glottic Closure Reflex

scholarly journals Glottic Closure Reflex

1981 ◽  
Vol 74 (5special) ◽  
pp. 1247-1261
Author(s):  
Mikikazu Yamagiwa ◽  
Yasuro Miyoshi ◽  
Yasuo Sakakura ◽  
Keizo Fukukita ◽  
Masahiko Kubo ◽  
...  
Keyword(s):  
Glottic Closure ◽  
Glottic Closure Reflex

Laryngeal Spasm: A Neurophysiologic Redefinition

1977 ◽  
Vol 86 (2) ◽  
pp. 150-157 ◽  
Author(s):  
Masafumi Suzuki ◽  
Clarence T. Sasaki
Keyword(s):  
Sensory Input ◽  
Superior Laryngeal Nerve ◽  
Spatial Summation ◽  
Laryngeal Nerve ◽  
Glottic Closure ◽  
Laryngeal Spasm ◽  
Afferent Nerves ◽  
Temporal And Spatial ◽  
Glottic Closure Reflex ◽  
Stimulation Of

Within the limits of standard neurophysiologic techniques, we have attempted to redefine laryngeal spasm as distinct from the glottic closure reflex. This distinction is based upon the observation that laryngeal spasm is solely mediated by the superior laryngeal nerve. Stimulation of other afferent nerves, capable of eliciting the glottic closure reflex, produces little adductor after-discharge activity that is characteristic of laryngeal spasm. In this regard, modification of output function from the adductor motoneuron aggregate by means of temporal and spatial summation of sensory input data has been described, and its characteristics further defined in response to varying ventilatory states and barbiturate levels.

Glottic Closure Reflex: Control Mechanisms

1980 ◽  
Vol 89 (3) ◽  
pp. 220-224 ◽  
Author(s):  
Taketsugu Ikari ◽  
Clarence T. Sasaki
Keyword(s):  
Partial Pressure ◽  
Superior Laryngeal Nerve ◽  
Intrathoracic Pressure ◽  
Lower Airway ◽  
Clear Understanding ◽  
Control Mechanisms ◽  
Arterial Partial Pressure ◽  
Glottic Closure ◽  
Life Threatening ◽  
Glottic Closure Reflex

Reflex glottic closure is a dominant and stable reflex produced by stimulation of the superior laryngeal nerve. Its precise execution is basic to successful sphincteric protection of the lower airway. In exaggerated form, it produces life-threatening laryngospasm. Clearly, reflex glottic closure and laryngospasm are facilitated by: a) expiratory phase; b) decreased arterial partial pressure of carbon dioxide (pCO2); c) increased arterial partial pressure of oxygen (pO2); and d) negative intrathoracic pressure. On the other hand, both reflex glottic closure and laryngospasm are inhibited by: a) inspiratory phase; b) increased arterial pCO2; c) decreased arterial pO2; and d) positive intrathoracic pressure. A clear understanding of laryngeal adductor control is an essential first step in the therapeutic modification of abnormal laryngeal closure and laryngospasm.

Central Facilitation of the Glottic Closure Reflex in Humans

2003 ◽  
Vol 112 (4) ◽  
pp. 293-297 ◽  
Author(s):  
Clarence T. Sasaki ◽  
Jagdeep Hundal ◽  
Basem Jassin ◽  
William Rosenblatt ◽  
Young-Ho Kim ◽  
...  
Keyword(s):  
Human Subjects ◽  
Superior Laryngeal Nerve ◽  
Lower Airway ◽  
Airway Protection ◽  
Minimal Alveolar Concentration ◽  
Internal Branch ◽  
Glottic Closure ◽  
Precise Understanding ◽  
Prolonged Sedation ◽  
Glottic Closure Reflex

The sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. We hypothesize that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Five patients during supraglottic laryngectomy underwent evoked response laryngeal electromyography under 0.5 and 1.0 minimal alveolar concentration (MAC) isoflurane anesthesia. The internal branch of the superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes, and recording electrodes were positioned in the ipsilateral and contralateral thyroarytenoid muscles. Consistent threshold responses were obtained ipsilaterally from 0.5 to 1.0 MAC anesthesia. However, the contralateral reflex responses approached 0% in successive trials as anesthetic levels approached 1.0 MAC. In human subjects, alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, predisposing to a weakened glottic closure response. A precise understanding of this effect may improve the prevention of aspiration in patients emerging from prolonged sedation or under heavy psychotropic control.

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