Airway and Respiration Parameters Improve Following Vocal Fold Medialization

Aşık, Mehmet Burak; Karasimav, Özlem; Bırkent, Hakan; Meratı, Albert L.; Gerek, Mustafa; Yıldız, Yavuz

doi:10.1177/0003489415593558

Cited by 22 publications

(30 citation statements)

References 19 publications

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“…As such, denervated mice exposed to a hypercapnic/hypoxic challenge to maximally increase their respiratory effort developed significantly impaired inspiratory flow, tidal volume, and minute ventilation at 11 WPS. Consistent with previous literature, inspiratory flow rate is often the most compromised spirometric parameter in human patients with unilateral VF paralysis (Asik et al, ). This outcome may be due to an increasingly atrophied and weakened VF that becomes flaccid and drawn into the inspiratory airstream, causing the VF to collapse and partially obstruct the airway.…”

Section: Discussionsupporting

confidence: 89%

Recurrent laryngeal nerve transection in mice results in translational upper airway dysfunction

Haney

Hamad

Woldu

et al. 2019

J of Comparative Neurology

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The recurrent laryngeal nerve (RLN) is responsible for normal vocal‐fold (VF) movement, and is at risk for iatrogenic injury during anterior neck surgical procedures in human patients. Injury, resulting in VF paralysis, may contribute to subsequent swallowing, voice, and respiratory dysfunction. Unfortunately, treatment for RLN injury does little to restore physiologic function of the VFs. Thus, we sought to create a mouse model with translational functional outcomes to further investigate RLN regeneration and potential therapeutic interventions. To do so, we performed ventral neck surgery in 21 C57BL/6J male mice, divided into two groups: Unilateral RLN Transection (n = 11) and Sham Injury (n = 10). Mice underwent behavioral assays to determine upper airway function at multiple time points prior to and following surgery. Transoral endoscopy, videofluoroscopy, ultrasonic vocalizations, and whole‐body plethysmography were used to assess VF motion, swallow function, vocal function, and respiratory function, respectively. Affected outcome metrics, such as VF motion correlation, intervocalization interval, and peak inspiratory flow were identified to increase the translational potential of this model. Additionally, immunohistochemistry was used to investigate neuronal cell death in the nucleus ambiguus. Results revealed that RLN transection created ipsilateral VF paralysis that did not recover by 13 weeks postsurgery. Furthermore, there was evidence of significant vocal and respiratory dysfunction in the RLN transection group, but not the sham injury group. No significant differences in swallow function or neuronal cell death were found between the two groups. In conclusion, our mouse model of RLN injury provides several novel functional outcome measures to increase the translational potential of findings in preclinical animal studies. We will use this model and behavioral assays to assess various treatment options in future studies.

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Section: Discussionsupporting

confidence: 89%

Recurrent laryngeal nerve transection in mice results in translational upper airway dysfunction

Haney

Hamad

Woldu

et al. 2019

J of Comparative Neurology

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“…Thirty patients underwent medialisation thyroplasty with a titanium implant, with preoperative and postoperative lung function testing recorded and analysed. Similar to Asik et al ’s8 study, there was no significant improvement in any of the parameters except for airway resistance; however, subjective improvement in respiration during speaking, laughing, coughing and physical activity was noted by all participants 9. Interestingly in 1999, Janas et al 10 conducted a similar study with 15 patients undergoing external medialisation surgery.…”

Section: Discussionsupporting

confidence: 55%

“…In 2015, Asik et al 8 assessed airway and respiratory parameters prospectively in patients undergoing laryngeal medialisation (either by injection laryngoplasty or thyroplasty for UVCP). Of the 11 patients who underwent thyroplasty, there was improvement in subjective airway measures; however, there was no significant improvement in spirometry (peak inspiratory and expiratory flow, FEV and FVC) 8.…”

Section: Discussionmentioning

confidence: 99%

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Improvement in lung function following medialisation thyroplasty in a postbilateral lung transplant patient

Hendriks¹,

Wormald

2018

BMJ Case Reports

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A 59-year-old man underwent external medialisation thyroplasty for his left unilateral vocal cord paralysis (UVCP) secondary to recent thoracic surgery. The patient had undergone bilateral lung transplant for idiopathic pulmonary fibrosis and was referred to the ear, nose and throat surgical team with new-onset voice hoarseness. Examination confirmed left UVCP, and after failing conservative management a decision was made to perform external medialisation thyroplasty. Following an uneventful procedure, the patient's phonation returned to normal, and remarkably on spirometry there was evidence of significant improvement in lung function. Despite case series demonstrating subjective improvement in respiration, this is the first documented case, to our knowledge, of significant improvement in spirometry following this procedure.

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“…More recently, VFA resulted in significantly fewer breaths, decreased mean phonatory airflow rate during voicing, and shorter inspiratory flow duration in patients with UVFP following augmentation . Recently, Asik et al found statistical improvement in both the MMRCDS and MBDS following VFA procedures, but spirometry values were unchanged . Interestingly, this cohort of patients presented with low levels of dyspnea symptoms prior to augmentation.…”

Section: Discussionmentioning

confidence: 76%

Impact of vocal fold augmentation and laryngoplasty on dyspnea in patients with glottal incompetence

et al. 2017

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Airway and Respiration Parameters Improve Following Vocal Fold Medialization

Abstract: Laryngeal medialization procedures such as IL and TT1 improve UVFP patients' respiration-related quality of life and aerodynamic performance with no significant changes in spirometry.

Cited by 22 publications

References 19 publications

Recurrent laryngeal nerve transection in mice results in translational upper airway dysfunction

Recurrent laryngeal nerve transection in mice results in translational upper airway dysfunction

Improvement in lung function following medialisation thyroplasty in a postbilateral lung transplant patient

Impact of vocal fold augmentation and laryngoplasty on dyspnea in patients with glottal incompetence

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