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Inspiratory Flow (inspiratory + flow)
Selected AbstractsRespiratory muscle performance with stretch-shortening cycle manoeuvres: maximal inspiratory pressure,flow curvesACTA PHYSIOLOGICA, Issue 3 2005G. E. Tzelepis Abstract Aim:, To test the hypothesis that the maximal inspiratory muscle (IM) performance, as assessed by the maximal IM pressure,flow relationship, is enhanced with the stretch-shortening cycle (SSC). Methods:, Maximal inspiratory flow,pressure curves were measured in 12 healthy volunteers (35 ± 6 years) during maximal single efforts through a range of graded resistors (4-, 6-, and 8-mm diameter orifices), against an occluded airway, and with a minimal load (wide-open resistor). Maximal inspiratory efforts were initiated at a volume near residual lung volume (RV). The subjects exhaled to RV using slow (S) or fast (F) manoeuvres. With the S manoeuvre, they exhaled slowly to RV and held the breath at RV for about 4 s prior to maximal inspiration. With the F manoeuvre, they exhaled rapidly to RV and immediately inhaled maximally without a post-expiratory hold; a strategy designed to enhance inspiratory pressure via the SSC. Results:, The maximal inspiratory pressure,flow relationship was linear with the S and F manoeuvres (r2 = 0.88 for S and r2 = 0.88 for F manoeuvre, P < 0.0005 in all subjects). With the F manoeuvre, the pressure,flow relationship shifted to the right in a parallel fashion and the calculated maximal power increased by approximately 10% (P < 0.05) over that calculated with the S manoeuvre. Conclusion:, The maximal inspiratory pressure,flow capacity can be enhanced with SSC manoeuvres in a manner analogous to increases in the force,velocity relationship with SSC reported for skeletal muscles. [source] Mechanisms of genioglossus responses to inspiratory resistive load in rabbitsACTA PHYSIOLOGICA, Issue 3 2002N. P. ALEKSANDROVA ABSTRACT The purpose of the present study has been to determine whether pharyngeal dilator muscles participate in inspiratory load compensatory responses and if so, to elucidate role of upper airway mechanoreceptors in these responses. The experiments were performed on anaesthetized rabbits. Each animal was tested in three ways by the imposition of inspiratory resistive load: (1) at upper airways via face mask, (2) at the tracheostomic cannula placed below larynx (all upper airway receptors were `bypassed') and (3) at the mouth after the section of the hypoglossus nerves (motor denervation of genioglossus muscle). The inspiratory load applied to the upper airways evoked significant increases in integrated genioglossus activity (to 129 ± 14.7% of control) and its inspiratory duration (to 113 ± 5% of control) already within the first loaded breath (P < 0.05). The increases in the inspiratory activity of musculius genioglossus were relatively greater than the simultaneous increases in the activity of the diaphragm. Motor denervation of the pharynx dilator muscles (including m. genioglossus) increased airway resistance to 184 ± 19% of control (P < 0.05) and induced obstructive alterations in the breathing pattern during unloaded breathing: decrease in maximal inspiratory flow (,13%) and increase in the level of negative oesophageal pressure (+14%) and the peak diaphragm activity (+6%). After nervi hypoglossus sections additional increases in motor and pressure outputs were required in order to maintain unaltered ventilation at the same degree of loading as before denervation. The results indicate that the pharyngeal dilator muscles have a role in compensation of added inspiratory load. Activation of these muscles facilitate the load compensating function of `pump' muscles by decreasing airway resistance. Tracheostomy did not reduce the genioglossus response to inspiratory loading, ruling out any role for upper airways receptors in the genioglossus response to inspiratory load compensations. [source] The combined effects of non-planarity and asymmetry on primary and secondary flows in the small bronchial tubesINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 2 2009B. Soni Abstract The laminar flow in the small bronchial tubes is quite complex due to the presence of vortex-dominated, secondary flows. In this paper, we report the results of a numerical investigation of the simultaneous effects of asymmetric and non-planar branching on the primary and secondary flows in the small bronchial tubes, i.e. generations 6,12. We simulate steady-state inspiratory flow at a Reynolds number of 1000 in three-generation, asymmetric planar and non-planar bronchial tube models. The non-planar model was defined by applying a 90° out-of-plane rotation to the third-generation branches. A detailed mesh refinement study was performed in order to demonstrate mesh independence. Significant differences were observed between flows in the planar and non-planar models. An uneven mass flow distribution was observed in the non-planar model in contrast to the evenly distributed mass flow in the planar model. The secondary flows created symmetric vortex patterns in the planar model, whereas vortex symmetry was lost in the non-planar model. These results illustrate the importance of incorporating asymmetry in addition to non-planarity in the geometric models. Copyright © 2008 John Wiley & Sons, Ltd. [source] The efficacy and safety of QVAR (hydrofluoroalkane-beclometasone diproprionate extrafine aerosol) in asthma (part 2): clinical experience in childrenINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2004C. P. Van Schayck Summary QVAR [hydrofluoroalkane-134a beclometasone dipropionate (BDP)] produces equivalent asthma control to chlorofluorocarbon-based BDP inhalers, at approximately half the daily dose in adults, a probable consequence of the increased lung deposition of QVAR that results from its greater fine particle fraction. Recent studies have relied on the clinical experience with QVAR in adults as a basis for investigations in childhood asthma. Design considerations, such as the use of the breath-actuated AutohalerÔ delivery device and measurement of direct health benefits, account for problems of variation in inspiratory flow, handling difficulties and low airways resistance that are associated with children. QVAR appears to be well tolerated in children with no clinically relevant adverse effects on adrenal function, bone metabolism or growth at recommended doses. [source] Forced inspiratory flow volume curve in healthy young childrenPEDIATRIC PULMONOLOGY, Issue 2 2009Daphna Vilozni PhD Abstract Introduction Spirometry testing should include both expiratory and inspiratory measurements. Inspiratory forced maneuvers can demonstrate extrathoracic airway abnormalities, of which various symptoms may suggest asthma. However, the inspiratory portion of the forced flow/volume maneuver in young healthy children has not yet been described. Objectives To document and analyze the forced inspiratory flow volume curve indices in healthy young children. Settings and Participants Healthy preschool children (age 2.5,6.5 years) from community kindergartens around Israel. Methods The teaching method included multi-target, interactive spirometry games and accessory games for inspiration (e.g., inspiratory whistle). Results One hundred and fourteen out of a total of 157 children performed duplicate full adequate inspiratory maneuvers. Repeatability between two maneuvers was 5.6%, 4.0%, 5.1%, 7.3% for inspiratory capacity (IC), forced inspiratory vital capacity (FIVC), peak inspiratory flow (PIF), and mid inspiratory flow (FIF50). Inspiratory flow indices were significantly lower than the expiratory flow indices. The time to reach PIF was significantly longer (mean,±,SD; 229,±,21 msec) than the time to reach peak expiratory flow (92,±,8 msec; P,<,0.0001). The shape of the inspiratory curve was parabolic and did not vary with age. The formed predicted equations were in agreement with the extrapolated values for older healthy children. Conclusions The majority of healthy young children can perform reliable maximum inspiratory flow volume curves. Our results provide a framework of reference equations for maximum inspiratory flow volume curve in the young children. The clinical applications of these equations have to be explored. Pediatr Pulmonol. 2009; 44:105,111. © 2009 Wiley-Liss, Inc. [source] Efficacy of pollen immunotherapy in seasonal allergic rhinitisPEDIATRICS INTERNATIONAL, Issue 1 2007DEMET CAN Abstract Background: The efficacy of subcutaneous pollen immunotherapy has been documented in published double-blind, placebo-controlled studies related to treatment of seasonal allergic rhinitis. In the present study, subjective (symptom scores) and objective (nasal peak inspiratory flow, nasal smear, nasal biopsy) parameters were used to study the efficacy of pollen immunotherapy. Methods: Forty-eight patients (32 male), mean ± SE age 13.6 ± 2.8 years allergic to grass-pollen participated in the present study. Patients were divided into three groups: group I, 24 patients who did not receive pollen immunotherapy; group II, 12 patients who received the build-up phase of pollen immunotherapy; and group III, 12 patients who had just finished pollen immunotherapy. With regard to objective and subjective parameters these three groups were compared. Results: When group I was compared to groups II and III, the patients who had not received any immunotherapy were found to have a high daytime nasal symptoms score (P < 0.01), high daytime eye symptoms score(P < 0.01) and high night-time symptoms score (P < 0.01). In objective parameters, it was found that group I had low nasal peak inspiratory flow (P < 0.05), and a high eosinophil count in nasal smears (P < 0.05) and peripheral blood (P < 0.05). It was also demonstrated that there was an increased eosinophil infiltration (P < 0.01) and mast cell infiltration (P < 0.05) in nasal biopsy in group I. There was no significant difference between group II and group III according to these results (P > 0.05). Conclusions: Immunotherapy leads to a better clinical and histopathological prognosis in children with seasonal allergic rhinitis. [source] Ability of preschool children to use dry powder inhalers as evaluated by In-Check MeterPEDIATRICS INTERNATIONAL, Issue 1 2006YOKO S ADACHI Abstract Background: Although current guidelines recommend the pressurized metered-dose inhaler with a spacer for preschool children with asthma, dry powder inhalers (DPI) may be a valuable treatment alternative. Methods: To evaluate the ability of preschool children to inhale through DPI, peak inspiratory flow rates (PIFR) of 57 healthy children aged 3,6 years were measured with In-Check Meter after practising with an instructor. Two different calibrated resistances were attached to the Meter to mimic the internal resistance of each inhaler; Diskus and Turbuhaler. Results: The ability of children to generate adequate inspiratory flow increased with age. The percentages of the 3-, 4-, 5-, and 6-year-old children who were able to inhale reliably through the devices were 30% (3/10), 79.0% (15/19), 100% (16/16), and 100% (12/12), respectively. In these children, 100%, 93.3%, 100%, and 100% achieved an adequate PIFR for the Diskus (30 L/min). In contrast, 66.7%, 66.7%, 62.5%, and 91.7% generated an adequate PIFR for the Turbuhaler (60 L/min). Conclusions: The In-Check Meter is a useful device to assess the ability of preschool children to generate adequate PIFR for each inhaler. Most children aged ,5 years could use DPI. [source] Flow,volume curve changes in patients with obstructive sleep apnoea and brief upper airway dysfunctionRESPIROLOGY, Issue 1 2000Alastair H Campbell Objective: Patients with obstructive sleep apnoea (OSA) and those with brief upper airway dysfunction (BUAD) have been reported to have abnormalities of maximal flow,volume curves. This study was designed to assess the ability of flow,volume curves to predict the presence of OSA or BUAD. Methodology: Four maximal flow,volume manoeuvres performed by 33 OSA patients and 16 BUAD patients were compared with those of 36 normal subjects. Flow,volume indices, their variability, saw-toothing in the curve and an algorithm based on the flow ratios and shape of the curves were assessed. Results: When the confounding factors, body mass index (BMI), age, gender and smoking status were taken into account, there was no significant difference in a variety of indices derived from the flow,volume curves between OSA and normal subjects. No BUAD patient had normal flow,volume curves as determined with the algorithm. After BMI, age, gender and smoking status were accounted for, decreased forced expiratory volume in 1 s (FEV1), and increased variability of peak expiratory flow (PEF)/peak inspiratory flow (PIF) and FEV1/PEF remained significantly associated with BUAD. Conclusions: These findings suggest that flow,volume curve indices have no value in predicting OSA. Some abnormalities are found in patients with BUAD; a normal flow,volume curve makes the diagnosis of BUAD unlikely. [source] Nasal congestion index: A measure for nasal obstructionTHE LARYNGOSCOPE, Issue 8 2009Thomas Kjaergaard MD Abstract Objectives: The relationship between congestion of the nasal mucosa and subjective nasal obstruction remains poorly defined. Applying the novel Nasal Congestion Index (NCI), we compared subjective nasal obstruction with objective measures for reversible congestion of the nasal mucosa. Study Design: A total of 2,523 consecutive patients were included in this cross-sectional study. Eligible subjects were adults referred to the ENT department, Sørlandet Hospital, Kristiansand, Norway, for evaluation of chronic nasal or sleep-related complaints. Methods: Subjects underwent acoustic rhinometry (AR) and peak nasal inspiratory flow (PNIF) at baseline and after decongestion of the nasal mucosa. Based on these registrations, an NCI was calculated for minimal cross-sectional area (MCA), nasal cavity volume (NCV), and PNIF, and employed for quantification of reversible mucosal congestion. Subjective nasal obstruction was measured by nasal obstruction visual analogue scales (NO-VAS). Statistical analyses were based on ANOVA and multiple linear and logistic regression, adjusting for age, gender, body mass index, asthma, allergy, smoking history, and type of planned intervention. Results: Crude estimates indicated that the NCIs were significantly higher in subjects with severe complaints of nasal obstruction compared with subjects with lesser symptoms (P < .001). These associations were confirmed by linear and logistic regression analyses. NCI for MCA, NCV, and PNIF showed highly significant associations with subjective nasal obstruction (P < .001). Conclusions: We have clearly demonstrated an association between subjective nasal obstruction and reversible congestion of the nasal mucosa by employing the NCI. The measure has proven to be useful for evaluating patients with complaints of nasal obstruction. Laryngoscope, 2009 [source] Optimising the unprotected airway with a prototype Jaw-Thrust-Device , a prospective randomised cross-over studyANAESTHESIA, Issue 11 2009A. Von Goedecke Summary Despite being a standard procedure during induction of anaesthesia, facemask ventilation can be a major challenge especially for inexperienced anaesthetists. We manufactured a Jaw-Thrust-Device designed to keep the patient's jaws in an optimised position, and thus to maintain the airway in a permanently patent state. Using a cross over design, we compared the influence of using the Esmarch manoeuvre (bimanual jaw-thrust), a nasopharyngeal airway, an oropharyngeal airway, or the Jaw-Thrust-Device on airway physiology in 50 healthy adults with body mass index < 35 kg.m,2, undergoing standard facemask ventilation for routine induction of anaesthesia. The main study endpoints were expiratory tidal volumes, airway resistances, and gas flow rates. The Jaw-Thrust-Device was more effective in increasing expiratory tidal volumes and peak inspiratory flow than a standard Esmarch manoeuvre, and was more effective than both nasopharyngeal and oropharyngeal airways in decreasing airway resistance. [source] Disconnect between standardized field-based testing and mannitol challenge in Scottish elite swimmersCLINICAL & EXPERIMENTAL ALLERGY, Issue 5 2010K. L. Clearie Summary Background Elite swimmers have high rates of rhinoconjunctivitis and exercise-induced bronchoconstriction. Moreover, exposure to chlorine and chlorine metabolites is known to induce bronchial hyper-reactivity. Objective To assess the early and late effects of chlorine and exercise on the unified airway of elite swimmers, and to compare the response to mannitol and field-based exercise challenge. Methods The Scottish national squad underwent exhaled tidal (FENO) and nasal (NNO) nitric oxide measurement, peak nasal inspiratory flow (PNIF), and forced expiratory volume in 1 s before, immediately after, and 4,6 h post-swimming. A sport-specific exercise test was carried out during an intensive lactate set (8 min at 80% maximum hear rate). All swimmers underwent mannitol challenge, and completed a health questionnaire. Results N=61 swimmers were assessed: 8/59 (14%) of swimmers had a positive mannitol challenge. Nine out of 57 (16%) of swimmers had a positive exercise test. Only one swimmer was positive to both. Swimmers with a positive mannitol had a significantly higher baseline FENO (37.3 vs. 18.0 p.p.b., P=0.03) than those with a positive exercise challenge. A significant decrease in FENO was observed pre vs. immediate and delayed post-chlorine exposure: mean (95% CI) 18.7 (15.9,22.0) p.p.b. vs. 15.9 (13.3,19.1) p.p.b. (P<0.01), and 13.9 (11.5,16.7) p.p.b. (P<0.01), respectively. There were no significant differences in NNO. Mean PNIF increased from 142.4 L/min (5.8) at baseline to 162.6 L/min (6.3) immediately post-exposure (P<0.01). Delayed post-exposure PNIF was not significantly different from pre-exposure. Conclusions No association was found between mannitol and standardized field-based testing in elite swimmers. Mannitol was associated with a high baseline FENO; however, exercise/chlorine challenge was not. Thus, mannitol may identify swimmers with a ,traditional' inflammatory asthmatic phenotype, while field-based exercise/chorine challenge may identify a swimmer-specific bronchoconstrictor response. A sustained fall in FENO following chlorine exposure suggests that a non-cellular, perhaps neurogenic, response may be involved in this group of athletes. Cite this as: K. L. Clearie, P. A. Williamson, S. Vaidyanathan, P. Short, A. Goudie, P. Burns, P. Hopkinson, K. Meldrum, L. Howaniec and B. J. Lipworth, Clinical & Experimental Allergy, 2010 (40) 731,737. [source] Topical treatment with aqueous solutions of rofleponide palmitate and budesonide in a pollen-season model of allergic rhinitisCLINICAL & EXPERIMENTAL ALLERGY, Issue 5 2004C. Ahlström-Emanuelsson Summary Background Rofleponide palmitate is an esterified glucocorticosteroid pro-drug with a promising pre-clinical profile designed to deliver topical airway treatment for allergic rhinitis and asthma in a novel manner. Thus, the rofleponide palmitate pro-drug is designed to provide topical exposure of the mucosa to the inactive lipophilic drug, which would be locally metabolized to the more hydrophilic and readily cleared drug rofleponide. Objective To examine whether rofleponide palmitate affects nasal symptoms and peak inspiratory flow (PIF) in a pollen-season model of allergic rhinitis and to compare any such effects with those of another glucocorticosteroid (i.e., budesonide). Methods During the pollen-free season, 40 patients with strictly seasonal allergic rhinitis received topical nasal spray treatment with an aqueous solution of rofleponide palmitate 400 ,g and an aqueous solution of budesonide 128 ,g once daily for 10 days in a double-blind, placebo-controlled, and crossover study. After 3 days of drug treatment, individualized allergen challenges were given once daily for 7 days while the treatment continued. The washout periods between each of the challenge series were 2 weeks. Nasal symptoms and PIF were recorded in the morning and evening, as well as 10 and 20 min after each allergen challenge. The mean recordings obtained during the last 3 days of the allergen-challenge series, when symptoms were established and when the treatment had lasted for 8,10 days, were used in the analysis. Results Both active treatments reduced nasal symptoms and improved nasal PIF compared with placebo (P<0.01,0.001). There was no overall difference in efficacy between rofleponide palmitate 400 ,g and budesonide 128 ,g. Conclusions Topical treatment with aqueous solutions of rofleponide palmitate attenuates nasal symptoms and improves nasal PIF in allergic rhinitis. The overall efficacy of 400 ,g of rofleponide palmitate is similar to that of 128 ,g of budesonide in the pollen-season model used in this study. [source] Increased nasal mucosal swelling in subjects with asthmaCLINICAL & EXPERIMENTAL ALLERGY, Issue 1 2002J. Hellgren Objective The objective of this study was to evaluate nasal mucosal swelling with acoustic rhinometry in subjects with asthma and in healthy controls. Methods We examined 184 individuals with asthma and compared with 156 randomly selected controls outside the pollen season, where 144 subjects in the asthma group and 80 controls had a previous history of non-infectious rhinitis (NIR). Nasal mucosal swelling was assessed with acoustic rhinometry before and after nasal decongestion with oxymetazoline and was analysed for the cross-sectional area (4 cm from the nostril) and the volume between 3.3 and 4 cm from the nostril. Symptom scores for nasal blockage, secretion, itching and sneezing were assessed on a 0,10 visual analogue scale as well as peak nasal inspiratory flow and spirometry. Results Before decongestion there was a decrease in the cross-sectional area at 4 cm (1.32 cm2 vs. 1.59 cm2, mean left + right P = 0.04) and in the volume (1.70 vs. 1.91 cm3P = 0.03) in the asthma group compared with healthy controls. After decongestion there were no significant differences in cross-sectional area at 4 cm (1.66 vs. 1.73 cm2P = 0.32) or volume (2.12 vs. 2.24 cm3P = 0.32). Combined nasal symptom scores were higher in the asthma group (1.8 vs. 0.8, P = 0.0001) and peak nasal inspiratory flow was lower (119 vs. 124 L/min, P = 0.38) than the healthy controls. FEV1 (% predicted) was also lower in asthma group (84 vs. 93%P < 0.0001). Conclusion We have been able to demonstrate an increased nasal mucosal swelling in a population sample of persons with asthma compared to healthy controls. These data support previous reports of a generalized airway inflammation in patients with asthma and suggest that acoustic rhinometry can be used to monitor the nasal mucosal swelling in these patients. [source] Does inhaling menthol affect nasal patency or cough?,PEDIATRIC PULMONOLOGY, Issue 6 2008MRCPCH, Priti Kenia MD (Paediatrics) Abstract Objective There is widespread use of menthol in over-the-counter medications, despite scant information on any beneficial effects. Our aim was to assess the effect of menthol on nasal air flow, perception of nasal patency and cough challenge testing. Materials and Methods Subjects comprised 42 healthy children aged 10 and 11 in a school setting. We used a single-blind pseudo-randomized cross-over trial to compare the effect of an inhalation of either menthol or placebo(eucalyptus oil). Baseline and post-intervention measurements were made on each of 2 consecutive days. Main outcome measures were (i) nasal expiratory and inspiratory flows and volumes, measured by spirometer, (ii) perception of nasal patency, assessed with a visual analogue scale (VAS), and (iii) the number of coughs in response to nebulized citric acid. Results There was no effect of menthol on any of the spirometric measurements. Following menthol, there was a significant increase in the perception of nasal patency (mean difference in log VAS (menthol-placebo),=,,0.207, 95%CI ,0.329, ,0.085). The cough count after menthol inhalation was reduced when compared to baseline but the change was not different from that after placebo (mean difference in cough count (menthol-placebo),=,,1.71, 95%CI ,4.11, 0.69). Conclusion Menthol has no effect on objective measures of flow but significantly increases the perception of nasal patency. It may not be possible to extrapolate these findings to younger children and those with rhinitis. Extending the study of menthol to these groups, including investigations of the efficacy and safety profiles, will provide further valuable evidence for its common use. Pediatr Pulmonol. 2008; 43:532,537. © 2008 Wiley-Liss, Inc. [source] Majority of children aged 3 years and above can reliably inhale through the ClickhalerPEDIATRIC PULMONOLOGY, Issue 1 2003Shaique M. Iqbal MRCPCH Abstract Guidelines suggest that pressurized metered dose inhalers (pMDI) plus spacers are the delivery system of choice for children. However, they are bulky, which makes them inconvenient. It was suggested that the smaller dry-powder inhalers (DPIs) may be suitable for delivering short-acting bronchodilators to preschool children. This study considered whether preschool children could reliably generate sufficient inspiratory flows to use the Clickhaler DPI. Twenty-seven asthmatic and 34 nonasthmatic children, aged 2,5 years, were recruited. Following training, they were asked to inhale four times through a Clickhaler flow monitoring system, twice "steadily" and twice "forcefully." Inspiratory flow data were collected during each inhalation. Of the 3-, 4-, and 5-year-old asthmatics, 62.5, 100, and 100%, respectively, could reliably differentiate between inhaling and exhaling through the DPI. For nonasthmatics, the figures were 66, 60, and 88%, respectively. All but one of the children who understood the instructions generated a PIF of greater than 15 l/min (range, 13.9,88.3 l/min and 21.2,84.5 l/min in asthmatic and nonasthmatic children, respectively). These data indicate that the majority of children aged 3 years and above could reliably inhale rather than exhale through a dry-powder inhaler, and that they generate inspiratory flows sufficient to use the Clickhaler effectively. The results indicate that the device could be a suitable delivery system for ,2 -agonists in preschool children. Pediatr Pulmonol. 2003; 36:63,68. © 2003 Wiley-Liss, Inc. [source] Improvement of respiratory compromise through abductor reinnervation and pacing in a patient with bilateral vocal fold impairment,THE LARYNGOSCOPE, Issue 1 2010Michael Broniatowski MD Abstract Objectives/Hypothesis. To determine whether respiratory compromise from bilateral vocal fold impairment (paralysis) can be objectively alleviated by reinnervation and pacing. Methods. A patient with paramedian vocal folds and synkinesis had a tracheotomy for stridor after bilateral laryngeal nerve injury and Miller Fisher syndrome. One posterior cricoarytenoideus (PCA) received a nerve-muscle pedicle fitted with a perineural electrode for pacemaker stimulation. The airway was evaluated endoscopically and by spirometry for up to 1 year. Results. Bilateral vocal fold patency during quiet breathing was reversed to active vocal fold adduction during tracheal occlusion. Peak inspiratory flows (PIFs) were significantly higher (P < .001) after reinnervation. PIFs and glottic apertures increased further under stimulation (42 Hz, 1,4 mA, 42,400 ,sec). although the differences were not significant. Conclusions. Based on our preliminary data, PCA reinnervation and pacing offer promise for amelioration of respiratory compromise after paradoxical adduction in bilateral vocal fold impairment. Laryngoscope, 2010 [source] | ||||||||||