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1.
Artigo em Chinês | MEDLINE | ID: mdl-36058664

RESUMO

Objective: To establish a rat model for laryngeal precancerous lesions histologically and pathologically comparable to the human counterpart. Methods: Thirty-six Wistar rats were randomly divided into experimental group and control group, with 18 rats in each group, and 1% 4-nitroquinoline-1-oxide (4NQO) solution and saline were respectively applied to the laryngeal mucosas of rats in two groups. During subsequent 20 weeks, the changes of laryngeal mucosas were regularly observed with naked eyes and endoscope and lesions were determined by histology. SPSS 22.0 software was used for statistical analysis. Results: The food intake, water intake and body weight of the rats in the experimental group were lower than those in the control group, with statistically significant differences (all P<0.05). White plaque, superficial ulcer, erosion and miliary particles were present in the larynxes of rats in the experimental group, with histological manifestations of atypical hyperplasia or carcinoma in situ, and normal epitheliums were shown in the control group. The number of Ki67 positive cells in the laryngeal mucosas of rats in the experimental group at the 4 th, 8 th, 12 th, 16 th, and 20 th weeks were 13.5±2.4, 35.6±5.8, 53.4±8.3, 78.8±11.6, 80.6±12.4, respectively, no Ki67 positive cells were found in the control group at individual time points, and the differences were statistically significant (t=9.74, 10.63, 11.14, 11.77, 11.26, respectively, all P<0.01). Conclusion: 4NQO can credibly cause rats laryngeal precancerous lesions, which morphologically and histologically mimic laryngeal carcinnogenesis. This method is practical, easy and reliable to prepare the animal model of laryngeal precancerous lesions.


Assuntos
Carcinoma in Situ , Carcinoma de Células Escamosas , Laringe , Lesões Pré-Cancerosas , Animais , Carcinoma de Células Escamosas/patologia , Humanos , Laringe/patologia , Lesões Pré-Cancerosas/induzido quimicamente , Lesões Pré-Cancerosas/patologia , Ratos , Ratos Wistar
2.
Neoreviews ; 23(9): e613-e624, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36047759

RESUMO

Respiratory distress in the neonate is one of the most common reasons for referral to a tertiary NICU, accounting for more than 20% of admissions. (1) The cause of respiratory distress can range from parenchymal lung disease to anomalies of any portion of the neonatal airway including the nose, pharynx, larynx, trachea, or bronchi. This review will focus on airway anomalies at or immediately below the level of the larynx. Although rare, those with such congenital or acquired laryngotracheal anomalies often require urgent evaluation and surgical intervention. This review describes 1) the pathophysiology associated with congenital and acquired laryngotracheal deformities in the neonate, 2) the clinical presentation and diagnostic evaluation of these anomalies, and 3) the current medical and surgical strategies available in the NICU and after discharge.


Assuntos
Doenças do Recém-Nascido , Laringe , Síndrome do Desconforto Respiratório , Brônquios , Humanos , Recém-Nascido , Laringe/anormalidades , Laringe/cirurgia , Traqueia
3.
Rom J Morphol Embryol ; 63(1): 153-160, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36074679

RESUMO

In the last decade, the incidence and mortality associated with laryngeal malignancies has experienced an unfavorable evolution in Romania, in terms of this pathology the country that has become the leader, among the European Union (EU)-27 countries. The aim of the present retrospective study was to analyze the epidemiological data regarding laryngeal cancer and histopathological (HP) particularities in patients diagnosed in Western Romania. Within three years and 10 months (during October 2016-July 2020) in Ear, Nose and Throat (ENT) Clinic of Timisoara Municipal Emergency Clinical Hospital, 194 patients with laryngeal neoplasms (LN) were diagnosed. Most of the patients were male (93.8%), from Timis County, mainly and the neighboring Counties of Caras-Severin, Hunedoara, Mehedinti and Arad. Patient's average age (both sexes) was 62.6 years, with a range from 38 to 84 years and the highest percentages in the 60+ age group (48%). Regarding smoker status, the main cause of the development of the LN, 93.9% of patients were active ones. Regarding localization [International Classification of Diseases 11th Revision (ICD-11)], about 69% were malignant neoplasm of glottis (C32.0), followed by supraglottis (C32.1), larynx-unspecified (C32.9), and subglottis (C32.2). From the HP point of view, several types of tumors were identified, most of which were non-keratinized and keratinized squamous cell carcinomas (about 90%). In addition, there were identified types of verrucous carcinoma, acantholytic carcinoma, squamous papilloma, a possible pleomorphic sarcoma, and pyogenic granuloma. The data presented in this study highlight the growing incidence of LN, which mainly affect men, at an increasingly young age. It is imperative to involve specialists from nutrition, general medicine, ENT, dentistry to start awareness programs and to develop prevention protocols.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Laríngeas , Laringe , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/patologia , Laringe/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Romênia/epidemiologia
4.
Vestn Otorinolaringol ; 87(4): 63-70, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36107183

RESUMO

The article provides a review of the literature on the development of chronic respiratory failure in patients with chronic cicatricial stenosis of the larynx and cervical trachea. The authors provide data on the etiology, pathogenetic features of the course of cicatricial stenosis of the larynx and trachea, the reasons for the development of chronic respiratory failure, the effect of hypoxemia on general metabolic processes in the body and on regeneration processes, as well as on methods of their correction and improvement of the postoperative period. The methods of respiratory impact on chronic respiratory failure in these patients are considered, based on the experience of a number of researchers and technical advances in recent years.


Assuntos
Laringe , Insuficiência Respiratória , Estenose Traqueal , Constrição Patológica/diagnóstico , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Hélio , Humanos , Laringe/cirurgia , Oxigênio , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/cirurgia , Estenose Traqueal/diagnóstico , Estenose Traqueal/etiologia , Estenose Traqueal/cirurgia
5.
Vestn Otorinolaringol ; 87(4): 113-117, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36107191

RESUMO

The report presents a case of non-standard two-stage treatment of post-traumatic multifocal cicatricial tracheal stenosis with atresia of subglottic larynx, involvement of vocal cords, and 33-year cannulation. At the first stage, bougienage through a tracheostomy, endoscopic argon plasma exposure, circular tracheoglottic resection with tracheostomy and 3/4 circle anastomosis, formation of a laryngotracheostomy with endoprosthetics were applied simultaneously. The second step was to eliminate the extensive fenestrated tracheo-laryngeal defect using titanium nickelide reinforcing implants. The individual algorithm made it possible to successfully eliminate complex tracheo-laryngeal stenosis with long-term cannulation and demonstrate excellent long-term treatment results.


Assuntos
Laringe , Gases em Plasma , Estenose Traqueal , Cateterismo , Constrição Patológica , Humanos , Laringe/cirurgia , Estenose Traqueal/diagnóstico , Estenose Traqueal/etiologia , Estenose Traqueal/cirurgia , Prega Vocal
6.
J Int Med Res ; 50(9): 3000605221122497, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36113014

RESUMO

Neurogenic tumors located in the larynx are extremely rare. Among them, schwannoma is a benign encapsulated tumor originating from Schwann cells, which form nerve fiber sheaths in the peripheral nervous system. We herein report a case of a schwannoma arising from a rare subsite of the larynx and review the literature on laryngeal schwannoma. The case involved a woman with a 1-month history of globus pharyngeus and dysphagia without dysphonia. Rigid laryngoscopy and magnetic resonance imaging showed a large submucosal bulge toward the medial wall of the right pyriform fossa, pushing the right false and true vocal cords and aryepiglottic fold inward. A transcervical approach was used to completely excise the tumor without incisional biopsy or preliminary tracheotomy. Histology confirmed a benign schwannoma originating from the right paraglottic space, which was extremely rare. During follow-up, no evidence of recurrence or a residual mass was found. The transcervical approach is a useful and less invasive treatment for laryngeal schwannoma located in the paraglottic space.


Assuntos
Neoplasias Laríngeas , Laringe , Neurilemoma , Feminino , Rouquidão/etiologia , Humanos , Neoplasias Laríngeas/patologia , Laringoscopia , Laringe/patologia , Neurilemoma/complicações , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2377-2380, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36083933

RESUMO

Many nerves and muscles are involved in the swallowing process; hence neuromuscular disorders cause dysphagia resulting in aspiration pneumonia. A critical movement in the pharyngeal phase of swallowing is hyolaryngeal elevation to help protect the airway and open a relaxed upper esophageal sphincter. Functional electrical stimulation (FES) is expected to improve the function of muscles acting on the hyolaryngeal motion, which may contribute to airway protection in dysphagic patients. However, it is difficult to select the stimulus locations that effectively assist laryngeal elevation without the expertise in the anatomy of swallowing-related muscles. Therefore, this study investigated the method to standardize the selection of the stimulus locations based on the dimensions of the larynx. In addition, the effect of stimulus intensity on the amount of laryngeal elevation was evaluated.


Assuntos
Transtornos de Deglutição , Laringe , Deglutição/fisiologia , Transtornos de Deglutição/diagnóstico , Estimulação Elétrica/métodos , Humanos , Laringe/fisiologia , Padrões de Referência
8.
Sci Rep ; 12(1): 14292, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-35995933

RESUMO

Glottis segmentation is a crucial step to quantify endoscopic footage in laryngeal high-speed videoendoscopy. Recent advances in deep neural networks for glottis segmentation allow for a fully automatic workflow. However, exact knowledge of integral parts of these deep segmentation networks remains unknown, and understanding the inner workings is crucial for acceptance in clinical practice. Here, we show that a single latent channel as a bottleneck layer is sufficient for glottal area segmentation using systematic ablations. We further demonstrate that the latent space is an abstraction of the glottal area segmentation relying on three spatially defined pixel subtypes allowing for a transparent interpretation. We further provide evidence that the latent space is highly correlated with the glottal area waveform, can be encoded with four bits, and decoded using lean decoders while maintaining a high reconstruction accuracy. Our findings suggest that glottis segmentation is a task that can be highly optimized to gain very efficient and explainable deep neural networks, important for application in the clinic. In the future, we believe that online deep learning-assisted monitoring is a game-changer in laryngeal examinations.


Assuntos
Glote , Laringe , Endoscopia , Glote/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Gravação em Vídeo
9.
J Acoust Soc Am ; 152(1): 302, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35931496

RESUMO

Voice therapy often emphasizes vibratory sensations in the front part of the vocal tract during phonation to improve vocal efficiency. It remains unclear what laryngeal and vocal tract adjustments are elicited in speakers by this emphasis on oral vibratory sensations. Using a three-dimensional phonation model, this study aims to identify laryngeal and epilaryngeal adjustments that might produce maximal oral vibratory sensations during phonation, as quantified by the oral sound pressure level (SPL), and thus are likely to be elicited in voice therapy at different semi-occluded vocal tract configurations. Results show that maximum oral SPL occurs at intermediate vocal fold adduction configurations characterized by a trade-off between glottal gap and vocal fold vertical thickness. Epilaryngeal tube narrowing further increases the oral SPL in an open vocal tract, but has little effect on oral SPL in semi-occluded vocal tracts. Laryngeal and epilaryngeal configurations producing the maximum oral SPL generally have lower peak vocal fold contact pressure when producing a target output SPL. These favorable configurations are more easily identified in open vocal tracts than semi-occluded vocal tracts. However, semi-occlusion increases both the mean and dynamic oral pressure, which may familiarize speakers with oral vibratory sensations and facilitate adoption of favorable laryngeal configurations.


Assuntos
Laringe , Voz , Humanos , Fonação , Sensação , Vibração , Prega Vocal
10.
Artigo em Chinês | MEDLINE | ID: mdl-36036077

RESUMO

Laryngeal cancer is one of the most common malignant cancer of the head and neck. Concurrent chemoradiotherapy is considered by the NCCN guideline to be the most effective organ protection strategy for locally advanced laryngeal cancer, which can preserve the larynx without reducing the survival rate of patients. Patients with non-T4 (T1-3) and high lymph node burden (N2-3) laryngeal cancer can benefit from concurrent chemoradiotherapy, which are more suitable for concurrent chemoradiotherapy than locally advanced laryngeal cancer with other stages. The indications of concurrent chemoradiotherapy were further discussed in this paper.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Laríngeas , Laringe , Protocolos de Quimioterapia Combinada Antineoplásica , Quimiorradioterapia , Cisplatino , Humanos , Taxa de Sobrevida
11.
J Speech Lang Hear Res ; 65(8): 2829-2845, 2022 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-35914018

RESUMO

PURPOSE: The goal of this study was to experimentally evaluate how compensating for the adverse acoustic effects of a posterior glottal opening (PGO) by increasing subglottal pressure and changing supraglottal compression, as have been associated with vocal hyperfunction, influences the risk of vocal fold (VF) trauma. METHOD: A self-oscillating synthetic silicone model of the VFs with an airflow bypass that modeled a PGO was investigated in a hemilaryngeal flow facility. The influence of compensatory mechanisms on collision pressure and dissipated collision power was investigated for different PGO areas and supraglottal compression. Compensatory behaviors were mimicked by increasing the subglottal pressure to achieve a target sound pressure level (SPL). RESULTS: Increasing the subglottal pressure to compensate for decreased SPL due to a PGO produced higher values for both collision pressure and dissipated collision power. Whereas a 10-mm2 PGO area produced a 12% increase in the peak collision pressure, the dissipated collision power increased by 122%, mainly due to an increase in the magnitude of the collision velocity. This suggests that the value of peak collision pressure may not fully capture the mechanisms by which phonotrauma occurs. It was also found that an optimal value of supraglottal compression exists that maximizes the radiated SPL, indicating the potential utility of supraglottal compression as a compensatory mechanism. CONCLUSIONS: Larger PGO areas are expected to increase the risk of phonotrauma due to the concomitant increase in dissipated collision power associated with maintaining SPL. Furthermore, the risk of VF damage may not be fully characterized by only the peak collision pressure.


Assuntos
Doenças da Laringe , Laringe , Glote , Humanos , Fonação , Silicones , Prega Vocal
12.
Science ; 377(6607): 760-763, 2022 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-35951711

RESUMO

Human speech production obeys the same acoustic principles as vocal production in other animals but has distinctive features: A stable vocal source is filtered by rapidly changing formant frequencies. To understand speech evolution, we examined a wide range of primates, combining observations of phonation with mathematical modeling. We found that source stability relies upon simplifications in laryngeal anatomy, specifically the loss of air sacs and vocal membranes. We conclude that the evolutionary loss of vocal membranes allows human speech to mostly avoid the spontaneous nonlinear phenomena and acoustic chaos common in other primate vocalizations. This loss allows our larynx to produce stable, harmonic-rich phonation, ideally highlighting formant changes that convey most phonetic information. Paradoxically, the increased complexity of human spoken language thus followed simplification of our laryngeal anatomy.


Assuntos
Evolução Biológica , Laringe , Fonação , Primatas , Fala , Prega Vocal , Animais , Humanos , Laringe/anatomia & histologia , Fonética , Acústica da Fala , Prega Vocal/anatomia & histologia
13.
Artigo em Chinês | MEDLINE | ID: mdl-35959576

RESUMO

Objective:To explore the selection of surgical methods and intraoperative strategies for the treatment of children with intractable laryngeal airway obstruction, and to provide new options for the diagnosis and treatment of children with intractable laryngeal airway obstruction. Methods:The clinical data of 12 children with intractable laryngeal airway obstruction treated by our team from January 2005 to December 2021 were retrospective analyzed. All the children were treated with minimally invasive surgery under rigid bronchoscope or suspension laryngoscope combined with electronic endoscope. The surgical methods included laryngeal microsurgery, plasma ablation, balloon dilatation, drug-eluting stents, laser ablation, endoscopic snare, etc. The patients were followed up after operation. Results:All patients completed the operation under general anesthesia, and there were no intraoperative or postoperative complications. Except for one patient with bilateral vocal cord paralysis who failed to extubation due to restenosis, the others were successfully extubated after operation. Among them, 9 cases of benign space-occupying obstruction were followed up for 5-60 months without recurrence, and 2 cases of malignant tumor-induced obstruction were followed up for 24 months(acinar cell carcinoma) and 36 months(mucoepidermoid carcinoma) without recurrence. Conclusion:Endoscopic multi-operation is effective for children with intractable obstruction. Compared with traditional thoracotomy, endoscopic multi-operation strategies has the advantages of less trauma, faster and safer. For different sizes, locations and pathological types of obstruction, different surgical equipment and methods should be combined.


Assuntos
Obstrução das Vias Respiratórias , Doenças da Laringe , Laringe , Paralisia das Pregas Vocais , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/cirurgia , Criança , Humanos , Estudos Retrospectivos
14.
Am J Otolaryngol ; 43(5): 103550, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35917657

RESUMO

OBJECTIVE: The larynx is the most common site of localized head and neck amyloidosis. Our study aimed to review the clinical features, treatments, and outcomes associated with localized laryngeal amyloidosis (LA). We also compared these features between two different time periods to evaluate the evolution of LA management. METHODS: A literature search using PubMed, CINAHL, Embase, and Cochrane Library identified cases of LA published between 1891 and 2021. Biopsy-proven cases of localized LA were included. Non-English studies, animal studies, and reviews were excluded. RESULTS: 282 patients (1891-1999: 142 patients, 2000-2021: 140 patients) from 129 studies were included. Results are reported as 1891-2000 vs. 2000-2021: Mean age was 48.5 years (range, 8-90 years) vs. 46.0 years (range, 9-84 years). The most common presenting symptoms were dysphonia (n = 30, 95 % vs. n = 127, 96 %) and difficulty breathing (n = 37, 27 % vs. n = 35, 27 %). A total of 62 (44 %) vs. 46 (33 %) lesions were found in the true vocal folds and 35 (25 %) vs. 59 (42 %) were found in the false vocal folds. 133 (94 %) vs. 137 (98 %) patients underwent surgical interventions to investigate and/or treat LA. Recurrent LA was reported in 27 (19 %) vs. 33 (24 %) patients with a mean time to recurrence of 25.4 months (range, 0.3-132 months) vs. 34.5 months (range, 0.8-144 months). Of cases reporting survival rate, 104 (97 %) vs. 107 (99 %) were alive at source study endpoints. CONCLUSION: LA typically exhibits an indolent course; therefore, early intervention may address longstanding symptoms. Recurrent disease poses a clinical challenge in patients with LA.


Assuntos
Amiloidose , Doenças da Laringe , Laringe , Amiloidose/diagnóstico , Amiloidose/patologia , Amiloidose/terapia , Rouquidão , Humanos , Doenças da Laringe/diagnóstico , Doenças da Laringe/patologia , Doenças da Laringe/terapia , Laringe/patologia , Prega Vocal/patologia
15.
Am J Otolaryngol ; 43(5): 103569, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35933964

RESUMO

OBJECTIVES: To study topical lidocaine for office-based laryngeal procedures recording onset, duration, and subjective experience of topical anesthesia. STUDY DESIGN: Nine healthy volunteers were anesthetized with 4 % lidocaine endoscopically. Laryngeal sensitivity prior to and during anesthesia was recorded until normal sensation returned measured by air-puff sensory testing. Subjective experience of the process was recorded. METHODS: Questionnaires regarding subjective experience were completed prior to, during, and after anesthesia. Laryngeal sensitivity via air-pulse trigger of the laryngeal adductor reflex (LAR) prior to and after 3 mL shower of 4 % lidocaine was recorded at 30 second intervals until the larynx was insensate with no LAR at 10 mmHg. Time to anesthesia was recorded and post-endoscopy questionnaire was given. Upon subjective change in sensation, sensitivity via air-pulse trigger of the LAR was recorded until baseline sensation returned. A post-anesthesia questionnaire recorded the subjective experience. RESULTS: Average time to full anesthesia was 110 s (±31.2). Subjective return of sensation was noted at 10 min (±2.5), however time to return to normal LAR was 22 min (±5.8). Based on three standard deviations, 99.7 % of the population will be anesthetized at 3.4 min, report subjective change at 18.2 min and regain full sensation at 40 min. CONCLUSIONS: Office-based laryngeal procedures should be performed at least 2 min following topical 4 % lidocaine with a window for manipulation of at least 16 min. Oral intake should be delayed for over 45 min to ensure complete return of sensation. The laryngeal shower of lidocaine is subjectively tolerated. LEVEL OF EVIDENCE: 2C Outcomes Research.


Assuntos
Laringe , Lidocaína , Anestesia Local/métodos , Anestésicos Locais , Humanos , Projetos Piloto , Reflexo
16.
J Craniofac Surg ; 33(6): e644-e647, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35968945

RESUMO

BACKGROUND: Laryngeal neurilemmoma, especially recurrent laryngeal neurilemmoma, is a rare neural sheath tumor in head and neck. The most common symptom of laryngeal neurilemmoma is hoarseness or dysphonia, followed by dysphagia, dyspnea, and foreign body sensation. At present, surgical resection is the most effective treatment for this kind of tumor, thus making how to remove it become the most concerned problem of surgeons. CASE PRESENTATION: On February 18, 2021, a 64-year-old male presented to our clinic with recurrent sore throat and intermittent hoarseness for 3 years. The results of electronic laryngoscope and magnetic resonance imaging showed a 25×10×21 mm well-defined tumor in the left pyriform sinus without laryngeal cartilage destruction and enlarged lymph nodes. After the initial diagnosis of recurrent laryngeal neurilemmoma, to preserve the continuity of recurrent laryngeal nerve as much as possible, the authors determine to perform anatomical resection of recurrent laryngeal neurilemmoma with operating microscope under the monitoring of recurrent laryngeal nerve function. Finally, the patient recovered completely from hoarseness during postoperative follow-up. CONCLUSION: A complete diagnosis and treatment process of recurrent laryngeal neurilemmoma was presented by the case. Particularly, it shows the application of recurrent laryngeal nerve monitoring in the operation helps to protect the continuity of the recurrent laryngeal nerve, which lays a anatomical bases for the follow-up nerve repair.


Assuntos
Laringe , Neoplasias de Bainha Neural , Neurilemoma , Rouquidão/etiologia , Rouquidão/cirurgia , Humanos , Laringe/patologia , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Nervo Laríngeo Recorrente/patologia , Nervo Laríngeo Recorrente/cirurgia
17.
Proc Natl Acad Sci U S A ; 119(29): e2121095119, 2022 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-35858334

RESUMO

The coordination of swallowing with breathing, in particular inspiration, is essential for homeostasis in most organisms. While much has been learned about the neuronal network critical for inspiration in mammals, the pre-Bötzinger complex (preBötC), little is known about how this network interacts with swallowing. Here we activate within the preBötC excitatory neurons (defined as Vglut2 and Sst neurons) and inhibitory neurons (defined as Vgat neurons) and inhibit and activate neurons defined by the transcription factor Dbx1 to gain an understanding of the coordination between the preBötC and swallow behavior. We found that stimulating inhibitory preBötC neurons did not mimic the premature shutdown of inspiratory activity caused by water swallows, suggesting that swallow-induced suppression of inspiratory activity is not directly mediated by the inhibitory neurons in the preBötC. By contrast, stimulation of preBötC Dbx1 neurons delayed laryngeal closure of the swallow sequence. Inhibition of Dbx1 neurons increased laryngeal closure duration and stimulation of Sst neurons pushed swallow occurrence to later in the respiratory cycle, suggesting that excitatory neurons from the preBötC connect to the laryngeal motoneurons and contribute to the timing of swallowing. Interestingly, the delayed swallow sequence was also caused by chronic intermittent hypoxia (CIH), a model for sleep apnea, which is 1) known to destabilize inspiratory activity and 2) associated with dysphagia. This delay was not present when inhibiting Dbx1 neurons. We propose that a stable preBötC is essential for normal swallow pattern generation and disruption may contribute to the dysphagia seen in obstructive sleep apnea.


Assuntos
Deglutição , Optogenética , Respiração , Centro Respiratório , Animais , Deglutição/fisiologia , Transtornos de Deglutição/fisiopatologia , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Interneurônios/fisiologia , Laringe , Camundongos , Camundongos Transgênicos , Neurônios Motores/fisiologia , Centro Respiratório/fisiologia
18.
Pol J Vet Sci ; 25(2): 325-334, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35861999

RESUMO

The present study investigated the chemical coding of neurons and nerve fibres in local laryngeal ganglia in pigs (n=5) using double-labelling immunohistochemistry. Virtually all the neurons were cholinergic in nature (ChAT- or VAChT-positive). Only very solitary, small nerve cells (presumably representing interneurons) stained intensely for adrenergic marker, DßH. Many neurons also contained immunoreactivity for NOS (91%), VIP (62.7%), NPY (24.7%), galanin (10%), SP (1.3%) and CGRP (5.3%). No neurons expressing somatostatin or Leu-enkephalin were observed. Nearly all the neuronal somata were densely supplied with varicose cholinergic nerve terminals, which presumably represented preganglionic axons, and some of them were also closely apposed with CGRP- and/or SP-positive varicose nerve endings, which were putative collaterals of extrinsic primary sensory fibres. In conclusion, this study has revealed that intrinsic neurons in the porcine larynx, like in many other mammalian species studied, should be classified as parasympathetic cholinergic neurons expressing biologically active substances, predominantly NOS and VIP. Furthermore, they are likely to receive inputs from not only preganglionic neurons but also primary sensory nerve cells. Finally, it appears that the information on the occurrence of the local laryngeal ganglia should be regularly included in textbooks dealing with the cranial portion of the parasympathetic nervous system in mammals.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina , Laringe , Animais , Peptídeo Relacionado com Gene de Calcitonina/análise , Colinérgicos/análise , Gânglios , Mamíferos , Neurônios , Suínos
19.
BMJ Case Rep ; 15(7)2022 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-35817484

RESUMO

Laryngeal histoplasmosis is a very rare cause of laryngitis which is encountered usually in the immunosuppressed states but can also occur in immunologically intact status. We report a rare case of laryngeal histoplasmosis in a man in his 60s, a chronic smoker who presented with a history of progressive hoarseness for 3 months. The glottic growth was biopsied. The rarity of diagnosis was aided by histopathological examination of the tissue, which revealed histoplasmosis. Management was done with intravenous liposomal amphotericin B and oral itraconazole with complete resolution of symptoms.


Assuntos
Histoplasmose , Laringe , Neoplasias , Antifúngicos/uso terapêutico , Histoplasmose/diagnóstico , Histoplasmose/tratamento farmacológico , Humanos , Itraconazol/uso terapêutico , Laringe/patologia , Masculino , Neoplasias/tratamento farmacológico
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