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Laryngeal Muscles (laryngeal + muscle)

Distribution by Scientific Domains

Medical Sciences	94%

Selected Abstracts

Timing of Human Insulin-Like Growth Factor-1 Gene Transfer in Reinnervating Laryngeal Muscle,

THE LARYNGOSCOPE, Issue 4 2004
Hideki Nakagawa MD
Abstract Objectives/Hypothesis The authors have designed a rat laryngeal paralysis model to study gene transfer strategies using a muscle-specific expression system to enhance local delivery of human insulin-like growth factor-1 (hIGF-1). In preliminary studies, a nonviral vector containing the ,-actin promoter and human hIGF-1 sequence produced both neurotrophic and myotrophic effects 1 month after single injection of plasmid formulation into paralyzed rat thyroarytenoid muscle in vivo. Based on these findings, it is hypothesized that the effects of hIGF-1 will enhance the results of laryngeal muscle innervation procedures. The timing of gene delivery relative to nerve repair is likely to be important, to optimize the results. Study Design Prospective analysis. Methods The effects of nonviral gene transfer for the delivery of hIGF-1 were evaluated in rats treated immediately following recurrent laryngeal nerve transection and repair and in rats receiving a delayed treatment schedule, 30 days after nerve transection and repair. Gene transfer efficiency was determined using polymerase chain reaction and reverse transcriptase,polymerase chain reaction techniques. Muscle fiber diameter, motor endplate length, and percentage of motor endplates with nerve contact were examined to assess hIGF-1 trophic effects. Results Compared with reinnervated untreated control samples, both early and delayed hIGF-1 transfer resulted in significant increase in muscle fiber diameter. Motor endplate length was significantly decreased and nerve/motor endplate contact was significantly increased following delayed gene transfer, but not after early treatment. Conclusion We infer from results of the study that delayed hIGF-1 gene transfer delivered by a single intramuscular injection will enhance the process of muscle reinnervation. The clinical relevance of these findings supports the future application of gene therapy using nonviral vectors for management of laryngeal paralysis and other peripheral nerve injuries. [source]

Effects of Insulin-Like Growth Factor-1 Gene Transfer on Myosin Heavy Chains in Denervated Rat Laryngeal Muscle,

THE LARYNGOSCOPE, Issue 2 2004
Paul W. Flint MD
Abstract Objectives/Hypothesis: To determine whether the myotrophic activity of human insulin-like growth factor (hIGF)-1 promotes restoration of normal myosin heavy chain (MHC) composition after nerve injury, MHC composition was analyzed after hIGF-1 gene transfer in denervated rat laryngeal muscle. Study Design: Animal model to study effects of gene transfer on laryngeal paralysis. Methods: In anesthetized rats, the left recurrent and superior laryngeal nerves are cut and suture ligated. A midline thyrotomy is performed, and the thyroarytenoid muscle is injected with a polyvinyl-based formulation containing a muscle specific expression system and hIGF-1 DNA (treatment group) or saline (control group). After 30 days, animals were killed, and the thyroarytenoid muscle was removed and processed for sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDSPAGE). Densitometric measurements were obtained to determine composition of MHCs. Results: As previously described, MHC composition in denervated laryngeal muscle was characterized by a decrease in type IIB and IIL and up-regulation of IIA/IIX. Compared with controls, hIGF-1 treated animals demonstrated a significant increase in expression of type IIB and IIL and a significant decrease in expression of type IIA/X. Conclusions: These findings suggest that the myotrophic effect of hIGF-1 gene transfer results in normalization of MHC composition in denervated muscle, with suppression of type IIA/X MHC and promotion of type IIL expression. [source]

Physiologic Features of Vocal Fatigue: Electromyographic Spectral-Compression in Laryngeal Muscles

THE LARYNGOSCOPE, Issue 6 2006
Victor J. Boucher PhD
Abstract Objectives: This study addresses the problem of defining observable attributes of "vocal fatigue" as a physiologic condition. The aim was to determine the applicability of electromyography (EMG) spectral compression in observing fatigue in laryngeal muscles arising from prolonged vocal effort. Study Design: Single institution, nonrandomized, prospective analysis of subjects evaluated in an academic, tertiary care center. Methods: In adapting EMG techniques, we report pretest observations that bear on the choice of voicing tasks serving to induce and estimate muscle fatigue and the selection of muscles that are particularly involved in effortful vocalization. On this basis, an experiment was designed where intramuscular EMG was used to record lateral cricoarytenoid potentials of seven subjects at regular intervals across a 12 to 14 hour period (50 samples per subject). Between each of these samples, the participants were required to produce loud speech for 3 minutes with peaks of 74 dBA at 1 meter. Results: The results show fatigue-related spectral compression for all subjects and nonlinear changes across time indicating critical values beyond which fatigue is persistent. Conclusion: Spectral compression appears to present a robust attribute of fatigue-related changes in muscles involved in vocalization. There are several implications with respect to research on the prevention of acquired voice pathologies. [source]

Effects of Insulin-Like Growth Factor-1 Gene Transfer on Myosin Heavy Chains in Denervated Rat Laryngeal Muscle,

Morphologic Correlates for Laryngeal Reinnervation,

THE LARYNGOSCOPE, Issue 11 2001
Richard R. Gacek MD
Abstract Objective To describe morphologic correlates for laryngeal reinnervation. Study Design Review of anatomic experiments dealing with laryngeal innervation performed over a 25-year period. Methods Description of results from experimental studies on the cat and human laryngeal muscles and nerve supply. Results Despite separation of abductor and adductor laryngeal motor neurons in the central nervous system, the mixture of abductor and adductor axons in the recurrent laryngeal nerve indicates that selective re-innervation of an individual laryngeal muscle must be accomplished at the neuromuscular junction (NMJ) of the muscle. The optimal time for a reinnervating neural source to re-occupy vacated NMJ is at the time of denervation. If the reinnervation procedure is attempted long (>1 mo) after denervation, extraneous end plates of other neural systems must be eliminated to provide vacant NMJ. The nerve muscle pedicle (NMP) concept is an effective model for reinnervation of a laryngeal muscle provided its activity pattern is similar to that of the denervated muscle and its insertion into vacated NMJ is timely. Conclusion NMP offers a logical method for selective laryngeal muscle reinnervation. Critical to the success of NMP are the physiological input to the NMP and timing of NMP implantation. [source]

Effect of neurotrophin-3 on reinnervation of the larynx using the phrenic nerve transfer technique

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 2 2007
Paul J. Kingham
Abstract Current techniques for reinnervation of the larynx following recurrent laryngeal nerve (RLN) injury are limited by synkinesis, which prevents functional recovery. Treatment with neurotrophins (NT) may enhance nerve regeneration and encourage more accurate reinnervation. This study presents the results of using the phrenic nerve transfer method, combined with NT-3 treatment, to selectively reinnervate the posterior cricoarytenoid (PCA) abductor muscle in a pig nerve injury model. RLN transection altered the phenotype and morphology of laryngeal muscles. In both the PCA and thyroarytenoid (TA) adductor muscle, fast type myosin heavy chain (MyHC) protein was decreased while slow type MyHC was increased. These changes were accompanied with a significant reduction in muscle fibre diameter. Following nerve repair there was a progressive normalization of MyHC phenotype and increased muscle fibre diameter in the PCA but not the TA muscle. This correlated with enhanced abductor function indicating the phrenic nerve accurately reinnervated the PCA muscle. Treatment with NT-3 significantly enhanced phrenic nerve regeneration but led to only a small increase in the number of reinnervated PCA muscle fibres and minimal effect on abductor muscle phenotype and morphology. Therefore, work exploring other growth factors, either alone or in combination with NT-3, is required. [source]

Effects of SZ1677, a new non-depolarizing steroidal neuromuscular blocking drug, and rocuronium on two laryngeal muscles and the anterior tibial muscle in guinea pigs

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2006
A. Michalek-Sauberer
Background:, SZ1677 is a new neuromuscular blocking drug structurally related to rocuronium. We compared the effect of an ED90 of SZ1677 (25 ,g/kg) with that of rocuronium (100 ,g/kg) in guinea pig laryngeal and peripheral muscles. Methods:, Electromyography was used to quantify neuromusc-ular blockade at the posterior cricoarytenoid muscle, the thyroarytenoid muscle and the anterior tibial muscle after SZ1677 (n = 10) and rocuronium (n = 9). Results:, Maximum neuromuscular blockade was similar after SZ1677 and rocuronium (83 ± 11% vs. 89 ± 11%; thyroarytenoid muscle: 91 ± 8% vs. 97 ± 3%; anterior tibial muscle: 91 ± 15% vs. 96 ± 3%, respectively). Onset time of neuromuscular blockade at the laryngeal muscles was similar for the two neuromuscular blocking drugs; it was shorter at the thyroarytenoid muscle (67 ± 32 s vs. 42 ± 40 s) than at the posterior cricoarytenoid muscle (101 ± 26 s vs. 102 ± 108 s). Onset time at the anterior tibial muscle was longer after SZ1677 (114 ± 34 s) than after rocuronium (68 ± 46 s); P < 0.05. Neuromuscular recovery was faster after SZ1677 (interval 25%,75%: posterior cricoarytenoid muscle: 222 ± 66 s; thyroarytenoid muscle: 192 ± 92 s; tibial muscle 149 ± 55 s) than after rocuronium (450 ± 148 and 464 ± 183 s, 292 ± 86 s, respectively); P < 0.05. Conclusions:, In guinea pigs, SZ1677 offers a rapid onset of neuromuscular blockade at a laryngeal adductor muscle with a shorter duration than rocuronium. Regardless of the drug used, the course of neuromuscular blockade differs not only between peripheral muscles and the larynx but also between antagonistic laryngeal muscles. The differences seem to be species specific. [source]

Sleep-related stridor due to dystonic vocal cord motion and neurogenic tachypnea/tachycardia in multiple system atrophy

MOVEMENT DISORDERS, Issue 5 2007
Roberto Vetrugno MD
Abstract Sleep-disordered breathing and sleep-related motor phenomena are part of the clinical spectrum of multiple system atrophy (MSA). Stridor has been attributed to denervation of laryngeal muscles or instead to dystonic vocal cord motion. We studied 3 patients with nocturnal stridor in the setting of MSA. All patients underwent nocturnal videopolysomnography (VPSG) with breathing and heart rate, O2 saturation and intra-esophageal pressure recordings, and simultaneous EMG recordings of the posterior cricoarytenoid, cricothyroid, and thyroarytenoid muscles and continuous vocal cord motion evaluation by means of fiberoptic laryngoscopy. VPSG/EMG and fiberoptic laryngoscopy documented normal vocal cord motion without denervation during wake and stridor only during sleep when hyperactivation of vocal cords adductors appeared in the absence of significant O2 desaturation. All patients had tachycardia and tachypnea and paradoxical breathing during sleep, erratic intercostalis and diaphragmatic EMG activity and Rem sleep behavior disorder. One of the patients had restless legs syndrome with periodic limb movement during sleep and excessive fragmentary hypnic myoclonus. In conclusion, our patients with MSA had nocturnal stridor due to sleep-related laryngeal dystonia. Stridor was associated with other abnormal sleep-related respiratory and motor disorders, suggesting an impairment of homeostatic brainstem integration in MSA. © 2007 Movement Disorder Society [source]

Myogenic precursor cells in craniofacial muscles

ORAL DISEASES, Issue 2 2007
LK McLoon
Craniofacial skeletal muscles (CskM), including the masticatory (MM), extraocular (EOM) and laryngeal muscles (LM), have a number of properties that set them apart from the majority of skeletal muscles (SkM). They have embryological origins that are distinct from musculature elsewhere in the body, they express a number of immature myosin heavy chain isoforms and maintain increased and distinct expression of a number of myogenic growth factors and their receptors from other adult SkMs. Furthermore, it has recently been demonstrated that unlike limb SkM, normal adult EOM and LM retain a population of activated satellite cells, the regenerative cell in adult SkM. In order to maintain this proliferative pool throughout life, CSkM may contain more satellite cells and/or more multipotent precursor cells that may be more resistant to apoptosis than those found in limb muscle. A further exciting question is whether this potentially more active muscle precursor cell population could be utilized not only for SkM repair, but be harnessed for repair or reconstruction of other tissues, such as nervous tissue or bone. This is a highly attractive speculation as the innate regenerative capacity of craniofacial muscles would ensure the donor tissue would not have compromised future function. [source]

Brainstem pathology in spasmodic dysphonia,

THE LARYNGOSCOPE, Issue 1 2010
Kristina Simonyan MD
Abstract Spasmodic dysphonia (SD) is a primary focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speech production. We examined two rare cases of postmortem brainstem tissue from SD patients compared to four controls. In the SD patients, small clusters of inflammation were found in the reticular formation surrounding solitary tract, spinal trigeminal, and ambigual nuclei, inferior olive, and pyramids. Mild neuronal degeneration and depigmentation were observed in the substantia nigra and locus coeruleus. No abnormal protein accumulations and no demyelination or axonal degeneration were found. These neuropathological findings may provide insights into the pathophysiology of SD. Laryngoscope, 2010 [source]

Changes of Extremity and Laryngeal Muscle Electromyographic Amplitudes After Intravenous Administration of Vecuronium,

THE LARYNGOSCOPE, Issue 12 2008
Yongbing Shi MD
Abstract Objectives: To compare electromyographic (EMG) amplitude changes in extremity and laryngeal muscles after vecuronium administration and study the effects of topical lidocaine on laryngeal EMG in a swine model. Study Design: Prospective animal study. Methods: Electrically evoked EMG activities were recorded from the vocalis muscles (directly and via an EMG endotracheal tube) and from the flexor digitorum muscles before and after intravenous vecuronium administration. EMG amplitudes were followed for 30 minutes after vecuronium injection together with monitoring of limb twitches to train-of-four stimulation. The testing was repeated after a 30-minute wash-out period and with topical lidocaine. Results: EMG amplitude recovery occurred sooner and more quickly in flexor digitorum muscle than in vocalis muscles. Reappearance of four twitches corresponded to EMG amplitude recovery to about 80% of the baseline in flexor digitorum muscles and to about half-baseline size in vocalis muscles. EMG amplitudes were generally lower at the start of the second round testing than the first round, with somewhat slower recovery in vocalis muscles. Conclusions: In contrast to reports by others in human studies, extremity muscles seem to be more resistant to vecuronium at 0.1 mg/kg than laryngeal muscles in the swine. Reappearance of four twitches corresponds to 50% of laryngeal EMG recovery and indicates adequate condition for monitoring electrically evoked laryngeal EMG activities. This study is inconclusive regarding the effects of topically applied lidocaine on laryngeal EMG amplitudes. Translation of these data to humans should be done with caution. [source]

Cortical Sensorimotor Control in Vocalization: A Functional Magnetic Resonance Imaging Study,

THE LARYNGOSCOPE, Issue 11 2008
Arno Olthoff MD
Abstract Background: Verbal communication is a human feature and volitional vocalization is its basis. However, little is known regarding the cortical areas involved in human vocalization. Methods: Therefore, functional magnetic resonance imaging at 3 Tesla was performed in 16 healthy adults to evaluate brain activations related to voice production. The main experiments included tasks involving motor control of laryngeal muscles with and without intonation. In addition, reference mappings of the sensorimotor hand area and the auditory cortices were performed. Results: Related to vocalization, in addition to activation of the most lateral aspect of the primary sensorimotor cortex close to the Sylvian fissure (M1c), we found activations medially (M1a) and laterally (M1b) of the well-known sensorimotor hand area. Moreover, the supplementary motor area and the anterior cingulate cortex were activated. Conclusions: Although M1a could be ascribed to motor control of breathing, M1b has been associated with laryngeal motor control. Consequently, even though M1c represents a laryngeal sensorimotor area, its exclusiveness as suggested previously could not be confirmed. Activations in the supplementary motor area and anterior cingulate cortex were ascribed to "vocal-motor planning." The present data provide the basis for further functional magnetic resonance imaging studies in patients with neurological laryngeal disorders. [source]

Quantitative Assessment of Laryngeal Muscle Morphology After Recurrent Laryngeal Nerve Injury: Right vs.

THE LARYNGOSCOPE, Issue 10 2008
Left Differences
Abstract Objectives/Hypothesis: Reports of laryngeal response to denervation are inconsistent. Some document atrophy and fibrosis in denervated laryngeal muscles, whereas others indicate resistance to atrophy. Spontaneous reinnervation has also been documented. The goal of this study was to clarify the effects of nerve injury and reinnervation on thyroarytenoid (TA) and posterior cricoarytenoid (PCA) muscles. Study Design: Laboratory experiment. Methods: TA and PCA muscles of cats were harvested 5 to 6 months after transecting right or left recurrent laryngeal nerve (RLN). Images of muscle cross-sections were acquired and studied using an image analysis workstation. Cross-sectional areas as well as total cross-sectional area of randomly selected muscle fibers were recorded. Results: TA reinnervation was robust on both sides, but there was less reinnervation of the PCA muscle after left-sided RLN lesion than after right-sided injury. Conclusions: Differences in reinnervation after RLN injury could contribute to the higher clinical incidence of left- vs. right-sided laryngeal paralysis. [source]