Pharyngeal Swallowing in Patients with Paresis of the Recurrent Nerve

1986 ◽  
Vol 27 (6) ◽  
pp. 697-700 ◽  
Author(s):  
O. Ekberg ◽  
S. Lindgren ◽  
T. Schultze
Keyword(s):  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Recurrent Nerve ◽  
Laryngeal Vestibule ◽  
Pharyngeal Swallowing ◽  
Thyroarytenoid Muscle

Pharyngolaryngeal function during swallowing was investigated cineradiographically in 22 patients with paresis of the recurrent nerve. Nineteen of these patients (86%) had defective closure of the laryngeal vestibule: 10 patients had defective apposition of the corniculate cartilages, (paresis of the oblique cricoarytenoid muscle), 9 patients had defective apposition of the arytenoid cartilages, (paresis of the interarytenoid muscle), 13 patients had defective movement of the epiglottis (paresis of, i.a. the thyrohyoid muscle), 1 patient had defective closure of the subepiglottic portion of the vestibule (paresis of the thyroepiglottic muscle), 2 patients had defective closure of the supraglottic portion of the vestibule (paresis of the superior ventricular segment of the thyroarytenoid muscle). Five patients with immobility of the epiglottis also had paresis of the pharyngeal constrictor musculature indicating paresis of the superior laryngeal nerve. Our investigation has shown that patients with paresis of the recurrent nerve who present with dysphagia with or without aspiration should be examined cineradiographically for pharyngolaryngeal function during swallowing.

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.

Topographic anatomy of the external branch of the superior laryngeal nerve

1984 ◽  
Vol 98 (11) ◽  
pp. 1121-1124 ◽  
Author(s):  
V. Kambič ◽  
M. Žargi ◽  
Zora Radšel
Keyword(s):  
At Risk ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Nodose Ganglion ◽  
Recurrent Nerve ◽  
Ganglion Nodosum ◽  
Topographic Anatomy ◽  
Supraglottic Laryngectomy ◽  
Accurate Knowledge ◽  
External Branch

AbstractThe authors have studied the anatomy of the external branch of the superior laryngeal nerve in its entirety on 40 fresh cadavers, and they have drawn the following conclusions: the nerve ramifies from the vagus immediately below the nodose ganglion or in the ganglion itself. The nerve splits into two branches approximately 1.5 cm below the ganglion nodosum. In four cases, both branches originated from the vagus itself. In one case, anastomosis of the external branch of the superior laryngeal nerve with the recurrent nerve was found. The external branch of the superior laryngeal nerve is not usually severed at supraglottic laryngectomy but the nerve is at risk during neck dissections, resection of Zenker's diverticula and thyroidectomy. An accurate knowledge of its course should reduce the incidence of injury to the branches of the superior laryngeal nerve during surgery.

Modulation of Laryngeal Responses to Superior Laryngeal Nerve Stimulation by Volitional Swallowing in Awake Humans

2000 ◽  
Vol 83 (3) ◽  
pp. 1264-1272 ◽  
Author(s):  
Julie M. Barkmeier ◽  
Steve Bielamowicz ◽  
Naoya Takeda ◽  
Christy L. Ludlow
Keyword(s):  
Electrical Stimulation ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Internal Branch ◽  
Increased Risk ◽  
Main Effect ◽  
Laryngeal Vestibule ◽  
Electrical Stimuli ◽  
Muscle Responses ◽  
Stimulation Of

Laryngeal sensori-motor closure reflexes are important for the protection of the airway and prevent the entry of foreign substances into the trachea and lungs. The purpose of this study was to determine how such reflexes might be modulated during volitional swallowing in awake humans, when persons are at risk of entry of food or liquids into the airway. The frequency and the amplitude of laryngeal adductor responses evoked by electrical stimulation of the internal branch of the superior laryngeal nerve (ISLN) were studied during different phases of volitional swallowing. Subjects swallowed water on command while electrical stimuli were presented to the ISLN at various intervals from 500 ms to 5 s following the command. Laryngeal adductor responses to unilateral ISLN stimulation were recorded bilaterally in the thyroarytenoid muscles using hooked wire electrodes. Early ipsilateral R1 responses occurred at 17 ms, and later bilateral R2 began around 65 ms. The muscle responses to stimuli occurring during expiration without swallowing were quantified as control trials. Responses to stimulation presented before swallowing, during the swallow, within 3 s after swallowing, and between 3 and 5 s after a swallow were measured. The frequency and amplitude of three responses (ipsilateral R1 and bilateral R2) relative to the control responses were compared across the different phases relative to the occurrence of swallowing. Results demonstrated that a reduction occurred in both the frequency and amplitude of the later bilateral R2 laryngeal responses to electrical stimulation for up to 3 s after swallowing ( P= 0.005). The amplitude and frequency of ipsilateral R1 laryngeal responses, however, did not show a significant main effect following the swallow ( P = 0.28), although there was a significant time by measure interaction ( P = 0.006) related to reduced R1 response amplitude up to 3 s after swallowing ( P = 0.021). Therefore, the more rapid and shorter unilateral R1 responses continued to provide some, albeit reduced, laryngeal protective functions after swallowing, whereas the later bilateral R2 responses were suppressed both in occurrence and amplitude for up to 3 s after swallowing. The results suggest that R2 laryngeal adductor responses are suppressed following swallowing when residues may remain in the laryngeal vestibule putting persons at increased risk for the entry of foreign substances into the airway.

Mucosal afferents mediate laryngeal adductor responses in the cat

2002 ◽  
Vol 93 (5) ◽  
pp. 1622-1629 ◽  
Author(s):  
Richard D. Andreatta ◽  
Eric A. Mann ◽  
Christopher J. Poletto ◽  
Christy L. Ludlow
Keyword(s):  
Superior Laryngeal Nerve ◽  
Surgical Excision ◽  
Laryngeal Nerve ◽  
The Body ◽  
Relative Contribution ◽  
Before And After ◽  
Peripheral Afferents ◽  
Proprioceptive Afferents ◽  
Thyroarytenoid Muscle ◽  
Stimulation Of

Laryngeal adductor responses (LAR) close the airway in response to stimulation of peripheral afferents in the superior laryngeal nerve. Although both mucosal afferents and proprioceptive receptors are present in the larynx, their relative contribution for reflex elicitation is unknown. Our purpose was to determine which receptor types are of importance in eliciting the LAR. A servomotor with displacement feedback was used to deliver punctate displacements to the body of the arytenoid cartilage and overlying mucosa on each side of the larynx in eight anesthetized cats. The same displacements were delivered both before and after surgical excision of the overlying mucosa. With the mucosa intact, early short-latency component R1 LAR responses recorded from the thyroarytenoid muscles were frequent (ipsilateral > 92%, contralateral > 95%). After the mucosa was removed, the LAR became infrequent (<3%) and was reduced in amplitude in both the ipsilateral and contralateral thyroarytenoid muscle recording sites ( P < 0.0005). These findings demonstrate that mucosal mechanoreceptors and not proprioceptive afferents contribute to the elicitation of LAR responses in the cat.

Characteristics of Late Responses to Superior Laryngeal Nerve Stimulation in Humans

1992 ◽  
Vol 101 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Christy L. Ludlow ◽  
Frederick Van Pelt ◽  
Junji Koda
Keyword(s):  
Muscle Activation ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Onset Latency ◽  
Internal Branch ◽  
Cricothyroid Muscle ◽  
External Branch ◽  
Muscle Responses ◽  
Thyroarytenoid Muscle ◽  
Stimulation Of

To characterize human thyroarytenoid and cricothyroid muscle responses to stimulation of the internal (sensory) and external (motor) branches of the superior laryngeal nerve (SLN), three awake subjects were studied at rest and during muscle activation with stimulation at different current levels. When only the external branch was stimulated, direct cricothyroid muscle responses were obtained without responses in either thyroarytenoid muscle. When only the internal branch was stimulated, no cricothyroid responses were obtained, but two late thyroarytenoid responses occurred (R1 and R2). The R1 response was usually ipsilateral and had a mean onset latency of 18 milliseconds, while the R2 response was bilateral and occurred between 66 and 70 milliseconds. Both responses tended to decrease in latency and increase in amplitude with increased stimulation level. The similarity of Rl to the adductor response and R2 to other late responses is discussed.

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