Contractile Properties of Canine Thyroarytenoid Muscle Reinnervated from the Ansa Cervicalis

1989 ◽  
Vol 98 (2) ◽  
pp. 153-156 ◽  
Author(s):  
Dale H. Rice ◽  
Donald S. Cooper
Keyword(s):  
Vocal Fold ◽  
Isometric Force ◽  
Thyroid Cartilage ◽  
Force Transducer ◽  
Contractile Properties ◽  
Distal Stump ◽  
Recurrent Nerve ◽  
Ansa Cervicalis ◽  
Thyroarytenoid Muscle ◽  
Indirect Stimulation

In an attempt to obtain data on the contractile properties of vocal fold muscle reinnervated from the ansa cervicalis, we severed the recurrent nerve and connected its distal stump to the ansa cervicalis by an end-to-end anastomosis in a series of dogs. Each dog was allowed to heal for 5 months. Then the section of the thyroid cartilage on which the vocal fold muscle inserted was detached, connected to an isometric force transducer, and activated by indirect stimulation successively on both the operated and unoperated sides. A series of twitch contractions was recorded from each side. In two dogs no contractile response was obtained. In the three others, the twitch contraction time was increased significantly, by 23% to 60%. In two of three dogs, the operated muscle was significantly weaker than the unoperated muscle. The reinnervated thyroarytenoid muscle changed its speed in the direction of the donor sternothyroid muscle.

Intraoperative Laryngeal Electromyographic Assessment of Patients with Immobile Vocal Fold

1992 ◽  
Vol 101 (10) ◽  
pp. 799-806 ◽  
Author(s):  
Peak Woo ◽  
Hernando Arandia
Keyword(s):  
Vocal Fold ◽  
Muscle Relaxation ◽  
Motor Units ◽  
Vocal Folds ◽  
Electrode Position ◽  
Recurrent Nerve ◽  
Laryngeal Paralysis ◽  
Vocal Fold Immobility ◽  
Hook Wire ◽  
Thyroarytenoid Muscle

The differential diagnosis of laryngeal ankylosis versus paralysis is occasionally difficult in patients with immobile vocal folds. Eight patients with acute and chronic evidence of vocal fold immobility were investigated by intraoperative electromyography (IEMG) during planned microlaryngoscopy. Bipolar hook wire electrodes were inserted into the thyroarytenoid muscle, of which the electrical activity was monitored during neuromotor blockade and emergence from anesthesia. The normal side and the side with ankylosis or stenosis showed normal IEMG activity. There was progressive recruitment of larger motor units during recovery from muscle relaxation. Patients with laryngeal paralysis failed to show such recruitment patterns. Thus, IEMG can be used as a diagnostic tool during operative laryngoscopy to differentiate neuromotor injury from anatomic causes of vocal fold immobility. The advantages of IEMG are its ease of application and certainty of electrode position. It can also be used to monitor recurrent nerve integrity and detect early laryngospasm. Further IEMG clinical study is warranted.

Function of the Thyroarytenoid Muscle in a Canine Laryngeal Model

1993 ◽  
Vol 102 (10) ◽  
pp. 769-776 ◽  
Author(s):  
Hong-Shik Choi ◽  
Ming Ye ◽  
Gerald S. Berke ◽  
Jody Kreiman
Keyword(s):  
Muscle Activity ◽  
High Frequency ◽  
Vocal Fold ◽  
Muscle Activation ◽  
Thyroid Cartilage ◽  
Vocal Folds ◽  
Vocal Fold Vibration ◽  
Thyroarytenoid Muscle

Fundamental frequency is controlled by contraction of the thyroarytenoid (TA) and cricothyroid (CT) muscles. While activity of the CT muscle is known to tense and thin the vocal folds, little is known about the effect of the TA muscle on vocal fold vibration. An in vivo canine laryngeal model was used to examine the role of the TA muscle in controlling phonation. Isolated TA muscle activation was obtained by stimulating sectioned terminal TA branches through small thyroid cartilage windows. Subglottic pressure measures, electroglottographic and photoglottographic signals, and acoustic signals were obtained in 5 mongrel dogs during dynamic and static variations in TA muscle activity. Results indicated that TA muscle activation is a major determinant in sudden shifts from high-frequency to modal phonation. Subglottic pressure increased and open quotient decreased gradually with increasing TA activation.

Treatment of unilateral vocal fold paralysis with ansa cervicalis to recurrent nerve anastomosis in a young adolescent: European case report

2018 ◽  
Vol 132 (7) ◽  
pp. 661-664 ◽  
Author(s):  
C van den Boer ◽  
A L Wiersma ◽  
J P Marie ◽  
J T van Lith-Bijl
Keyword(s):  
Case Report ◽  
Treatment Option ◽  
Vocal Fold ◽  
Voice Quality ◽  
Nerve Transfer ◽  
Analysis Data ◽  
Vocal Fold Paralysis ◽  
Recurrent Nerve ◽  
Unilateral Vocal Fold Paralysis ◽  
Ansa Cervicalis

AbstractBackgroundLaryngeal re-innervation in paediatric unilateral vocal fold paralysis is a relatively new treatment option, of which there has been little reported experience in Europe.MethodsIn this European case report of a 13-year-old boy with dysphonia secondary to left-sided unilateral vocal fold paralysis after cardiac surgery, the patient underwent re-innervation using an ansa cervicalis to recurrent laryngeal nerve transfer, in combination with fat augmentation, after 12 years of nerve denervation. Perceptual analysis data, and acoustic and laryngoscopy recordings were acquired pre-operatively, and at one and two years post-operatively.ResultsThe patient's perceptual voice quality was improved. He experienced subjective improvement and is very satisfied with the result. As expected, laryngoscopy at one and two years after surgery showed no physiological mobility of the vocal fold concerned, but improved closure during phonation was achieved. Electromyography showed evidence of re-innervation.ConclusionLaryngeal re-innervation could be considered as a treatment option for unilateral vocal fold paralysis in children and adolescents, even after a long-term delay.

Pseudomonas laryngeal perichondritis: unexpected diagnosis

2020 ◽  
Vol 13 (12) ◽  
pp. e237129
Author(s):  
Siti Salwa Zainal Abidin ◽  
Thean Yean Kew ◽  
Mawaddah Azman ◽  
Marina Mat Baki
Keyword(s):  
Diabetes Mellitus ◽  
Pseudomonas Aeruginosa ◽  
Vocal Fold ◽  
Histopathological Examination ◽  
Thyroid Cartilage ◽  
Tracheal Aspirate ◽  
Good Recovery ◽  
Antituberculous Drug ◽  
False Vocal ◽  
Oral Ciprofloxacin

A 57-year-old male chronic smoker with underlying diabetes mellitus presented with dysphonia associated with cough, dysphagia and reduced effort tolerance of 3 months’ duration. Videoendoscope finding revealed bilateral polypoidal and erythematous true and false vocal fold with small glottic airway. The patient was initially treated as having tuberculous laryngitis and started on antituberculous drug. However, no improvement was observed. CT of the neck showed erosion of thyroid cartilage, which points to laryngeal carcinoma as a differential diagnosis. However, the erosion was more diffuse and appeared systemic in origin. The diagnosis of laryngeal perichondritis was made when the histopathological examination revealed features of inflammation, and the tracheal aspirate isolated Pseudomonas aeruginosa. The patient made a good recovery following treatment with oral ciprofloxacin.

Cross-Innervation of the Thyroarytenoid Muscle by a Branch from the External Division of the Superior Laryngeal Nerve

1997 ◽  
Vol 106 (7) ◽  
pp. 594-598 ◽  
Author(s):  
Sina Nasri ◽  
Joel A. Sercarz ◽  
Pouneh Beizai ◽  
Young-Mo Kim ◽  
Ming Ye ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Spasmodic Dysphonia ◽  
Clinical Implications ◽  
Motor Innervation ◽  
Vocal Fold Vibration ◽  
Adductor Spasmodic Dysphonia ◽  
Thyroarytenoid Muscle ◽  
Stimulation Of

The neuroanatomy of the larynx was explored in seven dogs to assess whether there is motor innervation to the thyroarytenoid (TA) muscle from the external division of the superior laryngeal nerve (ExSLN). In 3 animals, such innervation was identified. Electrical stimulation of microelectrodes applied to the ExSLN resulted in contraction of the TA muscle, indicating that this nerve is motor in function. This was confirmed by electromyographic recordings from the TA muscle. Videolaryngostroboscopy revealed improvement in vocal fold vibration following stimulation of the ExSLN compared to without it. Previously, the TA muscle was thought to be innervated solely by the recurrent laryngeal nerve. This additional pathway from the ExSLN to the TA muscle may have important clinical implications in the treatment of neurologic laryngeal disorders such as adductor spasmodic dysphonia.

Monitoring Vocal Fold Abduction through Vocal Fold Contact Area

1988 ◽  
Vol 31 (3) ◽  
pp. 338-351 ◽  
Author(s):  
Martin Rothenberg ◽  
James J. Mahshie
Keyword(s):  
Contact Area ◽  
Time Variation ◽  
Vocal Fold ◽  
Thyroid Cartilage ◽  
Electrical Conductance ◽  
Vocal Folds ◽  
Linear Phase ◽  
Voice Production ◽  
Voiced Speech ◽  
High Pass

A number of commercial devices for measuring the transverse electrical conductance of the thyroid cartilage produce waveforms that can be useful for monitoring movements within the larynx during voice production, especially movements that are closely related to the time-variation of the contact between the vocal folds as they vibrate. This paper compares the various approaches that can be used to apply such a device, usually referred to as an electroglottograph, to the problem of monitoring the time-variation of vocal fold abduction and adduction during voiced speech. One method, in which a measure of relative vocal fold abduction is derived from the duty cycle of the linear-phase high pass filtered electroglottograph waveform, is developed in detail.

scholarly journals Corticosteroid effects on isotonic contractile properties of rat diaphragm muscle

1997 ◽  
Vol 83 (4) ◽  
pp. 1062-1067 ◽  
Author(s):  
Roland H. H. Van Balkom ◽  
Wen-Zhi Zhan ◽  
Y. S. Prakash ◽  
P. N. Richard Dekhuijzen ◽  
Gary C. Sieck
Keyword(s):  
Isometric Force ◽  
Contractile Properties ◽  
Diaphragm Muscle ◽  
Peak Power Output ◽  
Rat Diaphragm ◽  
Fiber Morphology ◽  
Shortening Velocity ◽  
Maximum Isometric Force ◽  
Induced Changes ◽  
Isotonic Contractions

Van Balkom, Roland H. H., Wen-Zhi Zhan, Y. S. Prakash, P. N. Richard Dekhuijzen, and Gary C. Sieck. Corticosteroid effects on isotonic contractile properties of rat diaphragm muscle. J. Appl. Physiol. 83(4): 1062–1067, 1997.—The effects of corticosteroids (CS) on diaphragm muscle (Diam) fiber morphology and contractile properties were evaluated in three groups of rats: controls (Ctl), surgical sham and weight-matched controls (Sham), and CS-treated (6 mg ⋅ kg−1 ⋅ day−1prednisolone at 2.5 ml/h for 3 wk). In the CS-treated Diam, there was a selective atrophy of type IIx and IIb fibers, compared with a generalized atrophy of all fibers in the Sham group. Maximum isometric force was reduced by 20% in the CS group compared with both Ctl and Sham. Maximum shortening velocity in the CS Diamwas slowed by ∼20% compared with Ctl and Sham. Peak power output of the CS Diam was only 60% of Ctl and 70% of Sham. Endurance to repeated isotonic contractions improved in the CS-treated Diam compared with Ctl. We conclude that the atrophy of type IIx and IIb fibers in the Diam can only partially account for the CS-induced changes in isotonic contractile properties. Other factors such as reduced myofibrillar density or altered cross-bridge cycling kinetics are also likely to contribute to the effects of CS treatment.

An Anatomic Study of the External Laryngeal Framework with Surgical Implications

1992 ◽  
Vol 106 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Lawrence Z. Meiteles ◽  
Pi-Tang Lin ◽  
Eugene J. Wenk
Keyword(s):  
Vocal Fold ◽  
Anterior Commissure ◽  
Thyroid Cartilage ◽  
Oblique Line ◽  
Type I ◽  
Anatomic Study ◽  
True Vocal Cord ◽  
Precise Knowledge ◽  
Human Cadavers ◽  
Superior Border

Precise knowledge of the level of the vocal fold as projected on the external thyroid cartilage is of critical importance for the performance of thyroplasty type I and supraglottic laryngectomy. Measurements of the external laryngeal framework were made on the larynges of 18 human cadavers in order to identify landmarks that will aid the surgeon in determining endolaryngeal anatomy. On the basis of our results, the following guidelines are recommended: (1) Thyroid cartilage incision for supra-glottic laryngectomy should be made on a line joining the juncture of the upper one third and lower two thirds of the midline length and the juncture of the upper one third and lower two thirds of the oblique line. This will ensure a position above the level of the anterior commissure and the true vocal cord; (2) In thyroplasty type I, the superior border of the thyroid cartilage window should be made at a line joining the midpoint of the midline length and the juncture of the upper two thirds and lower one third of the oblique line. Formation of the cartilage window according to this guideline will ensure its placement lateral to the vocalis muscle.

scholarly journals A Critical Reappraisal of Primary and Recurrent Advanced Laryngeal Cancer Staging

2018 ◽  
Vol 128 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Luca Giovanni Locatello ◽  
Michele Pietragalla ◽  
Cecilia Taverna ◽  
Luigi Bonasera ◽  
Daniela Massi ◽  
...  
Keyword(s):  
Squamous Cell ◽  
Vocal Fold ◽  
Thyroid Cartilage ◽  
Case Series ◽  
Staging System ◽  
Cancer Staging ◽  
Arytenoid Cartilage ◽  
Posterior Commissure ◽  
Diagnostic Pitfall ◽  
Pathologic Findings

Objectives: Laryngeal squamous cell carcinoma (LSCC) can involve different anatomic subunits with peculiar surgical and prognostic implications. Despite conflicting outcomes for the same stage of disease, the current staging system considers different lesions in a single cluster. The aim of this study was to critically discuss clinical and pathologic staging of primary and recurrent advanced LSCC in order to define current staging pitfalls that impede a precise and tailored treatment strategy. Methods: Thirty patients who underwent total laryngectomy in the past 3 years for primary and recurrent advanced squamous cell LSCC were analyzed, comparing endoscopic, imaging, and pathologic findings. Involvement of the different laryngeal subunits, vocal-fold motility, and spreading pattern of the tumor were blindly analyzed. The diagnostic accuracy and differences between clinicoradiologic and pathologic findings were studied with standard statistical analysis. Results: Discordant staging was performed in 10% of patients, and thyroid and arytenoid cartilage were the major diagnostic pitfalls. Microscopic arytenoid involvement was significantly more present in case of vocal-fold fixation ( P = .028). Upstaging was influenced by paraglottic and pre-epiglottic space cancer involvement, posterior commissure, subglottic region, arytenoid cartilage, and penetration of thyroid cartilage; on the contrary, involvement of the inner cortex or extralaryngeal spread tended to be down-staged. Radiation-failed tumors less frequently involved the posterior third of the paraglottic space ( P = .022) and showed a significantly worse pattern of invasion ( P < .001). Conclusions: Even with the most recent technologies, 1 in 10 patients with advanced LSCC in this case series was differently staged on clinical examination, with cartilage involvement representing the main diagnostic pitfall.

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