Endoscopic guidance system for stimulation of the laryngeal adductor reflex by droplet impact

2019 ◽  
Author(s):  
Jacob F. Fast ◽  
Adrian K. Rüppel ◽  
Caroline Bärhold ◽  
Michael Jungheim ◽  
Tobias Ortmaier ◽  
...  
Keyword(s):  
Droplet Impact ◽  
Guidance System ◽  
Endoscopic Guidance ◽  
Laryngeal Adductor Reflex ◽  
Stimulation Of

A NOVEL TELESURGICAL ENDOSCOPIC GUIDANCE SYSTEM AND CONTINGENCY PLAN FOR TREATMENT OF OBSTRUCTIVE NEPHROLITHIASIS DURING SPACE EXPLORATION

2008 ◽  
Vol 179 (4S) ◽  
pp. 542-542
Author(s):  
John C Kefer ◽  
Mihir M Desai ◽  
Monish Aron ◽  
George Pascal-Haber ◽  
Jim Thomas ◽  
...  
Keyword(s):  
Space Exploration ◽  
Guidance System ◽  
Contingency Plan ◽  
Endoscopic Guidance

Thyroarytenoid Muscle Responses to Air Pressure Stimulation of the Laryngeal Mucosa in Humans

2003 ◽  
Vol 112 (10) ◽  
pp. 834-840 ◽  
Author(s):  
Priyanka Bhabu ◽  
Christopher Poletto ◽  
Steven Bielamowicz ◽  
Eric Mann ◽  
Christy L. Ludlow
Keyword(s):  
Superior Laryngeal Nerve ◽  
Air Pressure ◽  
Button Press ◽  
Equal Frequency ◽  
Laryngeal Mucosa ◽  
Laryngeal Sensation ◽  
Laryngeal Adductor Reflex ◽  
Muscle Responses ◽  
Thyroarytenoid Muscle ◽  
Stimulation Of

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.

scholarly journals An actuated larynx phantom for pre-clinical evaluation of droplet-based reflex-stimulating laryngoscopes

2019 ◽  
Vol 5 (1) ◽  
pp. 137-140
Author(s):  
Jacob Friedemann Fast ◽  
Jiazhen He ◽  
Tobias Ortmaier ◽  
Michael Jungheim ◽  
Martin Ptok ◽  
...  
Keyword(s):  
Image Processing ◽  
Vocal Fold ◽  
High Speed ◽  
Droplet Impact ◽  
Alternative Methods ◽  
Onset Latency ◽  
Camera System ◽  
Protective Function ◽  
Impact Detection ◽  
Laryngeal Adductor Reflex

AbstractThe laryngeal adductor reflex (LAR) is an important protective function of the larynx to prevent aspiration and potentially fatal aspiration pneumonia by rapidly closing the glottis. Recently, a novel method for targeted stimulation and evaluation of the LAR has been proposed to enable non-invasive and reproducible LAR performance grading and to extend the understanding of this reflexive mechanism. The method relies on the laryngoscopically controlled application of accelerated water droplets in association with a high-speed camera system for LAR stimulation site and reflex onset latency identification. Prototype laryngoscopes destined for this method require validation prior to extensive clinical trials. Furthermore, demonstrations using a realistic phantom could increase patient compliance in future clinical settings. For these purposes, a model of the human larynx including vocal fold actuation for LAR simulation was developed in this work. The combination of image processing based on a custom algorithm and individual motorization of each vocal fold enables spatio-temporal droplet impact detection and controlled vocal fold adduction. To simulate different LAR pathologies, the current implementation allows to individually adjust the reflex onset latency of the ipsi- and contralateral vocal fold with respect to the automatically detected impact location of the droplet as well as the maximum adduction angle of each vocal fold. An experimental study of the temporal offset between desired and observed LAR onset latency due to image processing was performed for three average droplet masses based on highspeed recordings of the phantom. Median offsets of 100, 120 and 128 ms were found (n=16). This offset most likely has a multifactorial cause (image processing delay, inertia of the mechanical components, droplet motion). The observed offset increased with increasing droplet mass, as fluid oscillations after impact may have been detected as motion. In future work, alternative methods for droplet impact detection could be explored and the observed offset could be used for compensation of this undesirable delay.

scholarly journals A Review on the Current Applications of Artificial Intelligence in the Operating Room

2021 ◽  
pp. 155335062199696
Author(s):  
David C. Birkhoff ◽  
Anne Sophie H.M. van Dalen ◽  
Marlies P. Schijven
Keyword(s):  
Artificial Intelligence ◽  
Operating Room ◽  
Guidance System ◽  
Cochrane Library ◽  
Future Research ◽  
Surgical Safety ◽  
Analysis Workflow ◽  
Endoscopic Guidance ◽  
Clinical Conditions ◽  
Applications Of Ai

Background. Artificial intelligence (AI) is an era upcoming in medicine and, more recently, in the operating room (OR). Existing literature elaborates mainly on the future possibilities and expectations for AI in surgery. The aim of this study is to systematically provide an overview of the current actual AI applications used to support processes inside the OR. Methods. PubMed, Embase, Cochrane Library, and IEEE Xplore were searched using inclusion criteria for relevant articles up to August 25th, 2020. No study types were excluded beforehand. Articles describing current AI applications for surgical purposes inside the OR were reviewed. Results. Nine studies were included. An overview of the researched and described applications of AI in the OR is provided, including procedure duration prediction, gesture recognition, intraoperative cancer detection, intraoperative video analysis, workflow recognition, an endoscopic guidance system, knot-tying, and automatic registration and tracking of the bone in orthopedic surgery. These technologies are compared to their, often non-AI, baseline alternatives. Conclusions. Currently described applications of AI in the OR are limited to date. They may, however, have a promising future in improving surgical precision, reduce manpower, support intraoperative decision-making, and increase surgical safety. Nonetheless, the application and implementation of AI inside the OR still has several challenges to overcome. Clear regulatory, organizational, and clinical conditions are imperative for AI to redeem its promise. Future research on use of AI in the OR should therefore focus on clinical validation of AI applications, the legal and ethical considerations, and on evaluation of implementation trajectory.

Laryngeal Chemoreflex: Anatomic and Physiologic Study by use of the Superior Laryngeal Nerve in the Piglet

1987 ◽  
Vol 97 (1) ◽  
pp. 28-38 ◽  
Author(s):  
George S. Goding ◽  
Mark A. Richardson ◽  
Ronald E. Trachy
Keyword(s):  
Cardiovascular Response ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Nucleus Ambiguus ◽  
Central Projection ◽  
Apnea Duration ◽  
Laryngeal Mucosa ◽  
Laryngeal Adductor Reflex ◽  
Response To Water ◽  
Stimulation Of

The laryngeal chemoreflex (LCR) was investigated in 21 piglets (ages 6 to 80 days old) with the use of physiologic and histologic techniques. The central projection of the superior laryngeal nerve (SLN) was determined in 14 animals by use of horseradish peroxidase-wheat germ agglutinin. Ipsilateral labeling of the solitary tract nucleus was seen. The caudal extent of the labeling varied with age. Sensory labeling of the nucleus ambiguus was present bilaterally in three younger animals and unilaterally in older piglets. Bilateral labeling of the nucleus dorsomedialis was seen in all ages. Apneic and cardiovascular response to water stimulation of laryngeal mucosa and the laryngeal adductor reflex (LAR) were examined in 16 piglets. Blunting of the apneic and cardiovascular response was seen after sacrifice of a single SLN. Hypoxia did not significantly affect the LAR or apnea duration in animals with only one intact SLN. A contralateral LAR was found in younger animals. Relevance to the LCR is also discussed.

Neuronal Mechanisms Underlying the Laryngeal Adductor Reflex

2011 ◽  
Vol 120 (11) ◽  
pp. 755-760 ◽  
Author(s):  
Qi-Jian Sun ◽  
Jia Min Chum ◽  
Tara G. Bautista ◽  
Paul M. Pilowsky ◽  
Robert G. Berkowitz
Keyword(s):  
Action Potentials ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Short Latency ◽  
Occurrence Rate ◽  
Sprague Dawley ◽  
Single Action ◽  
Long Latency ◽  
Laryngeal Adductor Reflex ◽  
Stimulation Of

Objectives: Electromyographic studies of the laryngeal adductor reflex, glottal closure occurring in response to laryngeal stimulation, have demonstrated an early ipsilateral response (R1) and a late bilateral response (R2). To better define the physiologic properties of these responses, we recorded responses from expiratory laryngeal motoneurons (ELMs) in rats during stimulation of the superior laryngeal nerve (SLN). Methods: Single unit extracellular recordings were obtained from 5 ELMs, identified by their antidromic responses to recurrent laryngeal nerve stimulation and postinspiratory firing pattern, in 4 Sprague-Dawley rats. Results: Unilateral stimulation of the SLN (at 20 Hz) stopped both phrenic nerve inspiratory activity and ELM postinspiratory activity. However, the ELMs displayed robust tonic firing, consisting of non-respiratory burst activity and single action potentials. The single action potentials were identified as short-latency ones (5 to 10 ms) activated by ipsilateral SLN stimulation, with an occurrence rate of 90%, and long-latency ones (20 to 50 ms) activated by bilateral SLN stimulation, with occurrence rates of 47% on the ipsilateral side and 58% on the contralateral side. Conclusions: The R1 response appears to be the result of the short-latency action potentials, orthodromically activated by ipsilateral stimulation of the SLN. The R2 response is likely to be a result of the long-latency action potentials that can be recorded from ELMs on both sides.

A NOVEL TELESURGICAL ENDOSCOPIC GUIDANCE SYSTEM AND CONTINGENCY PLAN FOR TREATMENT OF OBSTRUCTIVE NEPHROLITHIASIS DURING SPACE EXPLORATION

2008 ◽  
Vol 179 (4S) ◽  
pp. 283-283
Author(s):  
John C Kefer ◽  
Mihir M Desai ◽  
Monish Aron ◽  
Georges-Pascal Haber ◽  
Jim Thomas ◽  
...  
Keyword(s):  
Space Exploration ◽  
Guidance System ◽  
Contingency Plan ◽  
Endoscopic Guidance

scholarly journals Stereo laryngoscopic impact site prediction for droplet-based stimulation of the laryngeal adductor reflex

IEEE Access ◽  
2021 ◽  
pp. 1-1
Author(s):  
Jacob F. Fast ◽  
Hardik R. Dava ◽  
Adrian K. Ruppel ◽  
Dennis Kundrat ◽  
Maurice Krauth ◽  
...  
Keyword(s):  
Impact Site ◽  
Site Prediction ◽  
Laryngeal Adductor Reflex ◽  
Stimulation Of

Effects of 5-5'-Diphenyl-2-thiohydantoin (DPTH) and Thyroxine on the Ultrastructure and Chemical Composition of Rat Liver

1971 ◽  
Vol 29 ◽  
pp. 570-571
Author(s):  
E. A. Elfont ◽  
R. B. Tobin ◽  
D. G. Colton ◽  
M. A. Mehlman
Keyword(s):  
Chemical Composition ◽  
Rat Liver ◽  
Future Study ◽  
Mode Of Action ◽  
Liver Mitochondria ◽  
Rat Liver Mitochondria ◽  
Effective Inhibitor ◽  
Biochemical Effects ◽  
Glycerophosphate Dehydrogenase ◽  
Stimulation Of

Summary5,-5'-diphenyl-2-thiohydantoin (DPTH) is an effective inhibitor of thyroxine (T4) stimulation of α-glycerophosphate dehydrogenase in rat liver mitochondria. Because this finding indicated a possible tool for future study of the mode of action of thyroxine, the ultrastructural and biochemical effects of DPTH and/or thyroxine on rat liver mere investigated.Rats were fed either standard or DPTH (0.06%) diet for 30 days before T4 (250 ug/kg/day) was injected. Injection of T4 occurred daily for 10 days prior to sacrifice. After removal of the liver and kidneys, part of the tissue was frozen at -50°C for later biocheailcal analyses, while the rest was prefixed in buffered 3.5X glutaraldehyde (390 mOs) and post-fixed in buffered 1Z OsO4 (376 mOs). Tissues were embedded in Araldlte 502 and the sections examined in a Zeiss EM 9S.Hepatocytes from hyperthyroid rats (Fig. 2) demonstrated enlarged and more numerous mitochondria than those of controls (Fig. 1). Glycogen was almost totally absent from the cytoplasm of the T4-treated rats.

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