Document Detail

A computational study of the role of the aortic arch in idiopathic unilateral vocal fold paralysis.
MedLine Citation:
PMID:  25477351     Owner:  NLM     Status:  Publisher    
Unilateral vocal fold paralysis (UVP) occurs when one of the vocal folds becomes paralyzed due to damage to the recurrent laryngeal nerve (RLN). Individuals with UVP experience problems with speaking, swallowing and breathing. Nearly 2/3 of all cases of UVP are associated with impaired function of the left RLN. The left RLN branches from the vagus nerve within the thoracic cavity and loops around the aorta before ascending to the larynx within the neck. We hypothesize that this path predisposes the left RLN to a supraphysiological biomechanical environment contributing to onset of UVP. Specifically, this research focuses on identifying the contribution of the aorta to onset of left-sided UVP. Important to this goal is determining the relative influence of the material properties of the RLN and the aorta in controlling the biomechanical environment of the RLN. Finite element analysis was used to estimate the stress and strain imposed on the left RLN as a function of the material properties and loading conditions. The peak stress and strain in the RLN was quantified as a function of RLN and aortic material properties and aortic blood pressure using Spearman rank correlation coefficients. The material properties of the aortic arch showed the strongest correlation with peak stress (ρ = -0.63, 95% CI, -1.00 to -0.25) and strain (ρ=-0.62, 95%CI, -0.99 to -0.24) in the RLN. Our results suggest an important role for the aorta in controlling the biomechanical environment of the RLN and potentially in the onset of left-sided UVP that is idiopathic.
Megan J Williams; Avinash Ayyalasomayajula; Reza Behkam; Andrew J Bierhals; M Eileen Jacobs; Julia D Edgar; Randal C Paniello; Julie M Barkmeier-Kraemer; Jonathan P Vande Geest
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-12-4
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  -     ISSN:  1522-1601     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-5     Completed Date:  -     Revised Date:  2014-12-6    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  jap.00638.2014     Citation Subset:  -    
Copyright Information:
Copyright © 2014, Journal of Applied Physiology.
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