Improving the Utility of Laryngeal Adductor Reflex Testing: A Translational Tale of Mice and Men.

Autor: Shock LA; University of Missouri School of Medicine, Columbia, Missouri, USA., Gallemore BC; University of Missouri School of Medicine, Columbia, Missouri, USA., Hinkel CJ; University of Missouri School of Medicine, Columbia, Missouri, USA., Szewczyk MM; University of Missouri School of Medicine, Columbia, Missouri, USA., Hopewell BL; University of Missouri School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Columbia, Missouri, USA., Allen MJ; University of Missouri School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Columbia, Missouri, USA., Thombs LA; University of Missouri, Department of Statistics, Columbia, Missouri, USA., Lever TE; University of Missouri School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Columbia, Missouri, USA levert@health.missouri.edu.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2015 Jul; Vol. 153 (1), pp. 94-101. Date of Electronic Publication: 2015 Apr 01.
DOI: 10.1177/0194599815578103
Abstrakt: Objectives: Evaluation of the laryngeal adductor reflex (LAR) entails delivering air through an endoscope positioned 1 to 2 mm from the arytenoid mucosa to elicit bilateral vocal fold (VF) closure. This short working distance limits visualization to only the ipsilateral arytenoid and results in quantification of a single LAR metric: threshold pressure that evokes the LAR. Our goal was to evolve the LAR procedure to optimize its utility in clinical practice and translational research.
Study Design: Prospective translational experiment.
Setting: Academic institution.
Subjects: Young healthy human adults (n = 13) and 3 groups of mice: healthy, primary aging mice (n = 5), a transgenic mouse model of amyotrophic lateral sclerosis (ALS; n = 4), and young healthy controls (n = 10).
Methods: The VFs were visualized bilaterally during supramaximal air stimulation through an endoscope. Responses were analyzed to quantify 4 novel metrics: VF adduction phase duration, complete glottic closure duration, VF abduction phase duration, and total LAR duration.
Results: The 4 LAR metrics are remarkably similar between healthy young humans and mice. Compared to control mice, aging mice have shorter glottic closure durations, whereas ALS-affected mice have shorter VF abduction phase durations.
Conclusions: We have established a new LAR protocol that permits quantification of novel LAR metrics that are translatable between mice and humans. Using this protocol, we showed that VF adduction is impaired in primary aging mice, whereas VF abduction is impaired in ALS-affected mice. These preliminary findings highlight the enhanced diagnostic potential of LAR testing.
(© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.)
Databáze: MEDLINE
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