Characteristics of an in vivo canine model of phonation with a constant air pressure source

Magnetoelastic sensors as a new tool for laryngeal research

CONCLUSIONS

The use of custom-built magnetoelastic sensors designed for insertion in the larynx to measure the force of transverse deformation of the thyroarytenoid and cricothyroid muscles was examined.

OBJECTIVES

The availability of sensors that transduce deformation force into an electrical current (measurable in millivolts) suggested that such sensors could be used to study muscle function in the canine larynx. This study aimed to obtain information about the force exercised by larynx muscles on the sensor in an experiment in vivo.

MATERIALS AND METHODS

The results of six surgical interventions in three dogs using four magnetoelastic sensors are described. The sensor and insertion technique were atraumatic. One dog underwent surgery four times to study the morbidity, reliability and reproducibility of the technique. An electromyographic recording was made at the same time that sensor response was registered to compare results with a standardized technique.

RESULTS

We obtained 584 regular responses: 256 deglutitions (150 thyroarytenoid and 106 cricothyroid recordings) and 328 phonations (223 thyroarytenoid and 105 cricothyroid recordings). No signs of injury or functional deficit were observed after any intervention. In the dog that underwent four interventions, results were consistent after each intervention.

Estimation of alveolar pressure during speech using direct measures of tracheal pressure

The pressure in the alveoli of the lungs, created by the elastic recoil of the lungs and respiratory muscle activity, is referred to as alveolar pressure (Pa). The extent to which tracheal pressure (Pt) approximates Pa depends on the resistance to airflow offered by structures above and below the point at which tracheal pressure is measured. An understanding of the relationship among Pa, Pt, and upper and lower airway resistance, and how these values fluctuate during speech, could aid in interpretation and modeling of speech aerodynamics. The purpose of this study was to (a) obtain values for lower airway resistance (Rlow), (b) use these Rlow values to estimate Pa during speech, and (c) quantify the degree to which Pt approximates Pa during production of voiced and voiceless sounds, in comparison to inhalation. In addition, the results were discussed in terms of the degree to which the respiratory system functions as a pressure source. Tracheal pressure (obtained with tracheal puncture) and airflow were measured during sentence production in 6 subjects. Using a technique introduced in this paper, Rlow was determined from measures of tracheal pressure and flow obtained during a sudden change in upper airway resistance because of release of a voiceless plosive. Mean Rlow values ranged from 0.14 to 0.32 kPa/(l/s). Each subject's mean Rlow was used to derive a time-varying measure of Pa during speech from continuous measures of tracheal pressure and airflow. Pt was approximately 95% of Pa during phonation (i.e., when the vocal folds were adducted), 75% of Pa during release of the voiceless stop consonant /p/, and 55% of Pa during inhalation (i.e., when the vocal folds were abducted). Therefore, the degree to which the respiratory system functioned as an ideal pressure source varied during speech. The ability to estimate Pa provides a measure of the pressure produced by the respiratory system that is not influenced by laryngeal activity.

Histomorphometric and laryngeal videostroboscopic analysis of the effects of corticosteroids on microflap healing in the dog larynx

The histologic and functional effects of unilateral, layered corticosteroids on lateral microflap healing in 15 dogs were analyzed. Histologic sections of steroid-treated vocal folds (VFs) were studied with computer morphometry to examine differences in the tissue healing response. Paired analysis revealed increases in the inflammatory infiltrate around the microflap in the steroid-treated VFs at 2, 4, and 6 weeks (6.3%, 30.6%, and 34.9%, all with p < .02). The neovascular response in the steroid-treated VFs was less at 2 weeks (-20.9%, p < .005) but greater at 4 and 6 weeks (16.3% and 4.3%, p < .005). To better characterize the effect of steroids on the healing process, a normal, time-dependent distribution was applied to the histologic data and demonstrated a delay in the steroid-treated VF tissue response of 12 days for the inflammatory infiltrate and 21 days for the neovascular response. Qualitative and quantitative analysis of in vivo laryngeal videostroboscopy (LVS) samples taken preoperatively and at sacrifice could not identify significant differences in appearance, amplitude, mucosal wave, or suppleness between the 2 VFs. Therefore, although corticosteroids cause a delay in wound healing, LVS does not discern differences in microflap characteristics between healing steroid-treated and control VFs at 2, 4, or 6 weeks. If steroids are used, the surgeon should account for a probable delay in wound healing, but should not expect an overall difference in functional outcome.

Cross-innervation of the thyroarytenoid muscle by a branch from the external division of the superior laryngeal nerve

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.