NORMAL PHYSIOLOGY, PATHOPHYSIOLOGY, AND TREATMENT OF VOICE DISORDERS

神经递质参与喉部的研究 感官马达 道路正在铺设中。延髓中的区域 先前 被认为与喉声门炎有关的功能性疾病 闭关 对反射进行研究，以确定哪种兴奋性氨基酸 受体 在这种反射中发挥作用。对AMPA具有选择性的分布 谷氨酸受体亚单位(GluR1-GluR4)与NMDA受体 亚单位 NMDAR1也进行了研究。对所有抗体进行染色 发现 在孤束核中。然而，集中在 GluR1 在间质中显著大于NMDAR1或GluR4 亚核，以前发现的与喉部相关的区域 闭关 反射反应。 还完成了一项研究，检查了肌肉的模式 活动 声带麻痹患者的甲状旁肌 特发性的源于特发性或神经损伤后的。全 患者有 持续性麻痹伴甲状旁肌再神经支配。至 检查是否有联会的证据，双极电极记录 是 由在呼吸和呼吸过程中激活的甲状旁肌组成 发声。除一名患者外，其余患者的肌肉活动均正常。 呼吸和发声的激活幅度和模式。 这些结果表明，甲颧肌不是 受影响 通过联动。其他肌肉和关节固定需 评估 为了确定持续性瘫痪的基础，尽管 神经再支配。 肉毒杆菌毒素损伤后的病理生理变化 内收肌痉挛发音困难患者的注射， 甲颧骨 和环甲肌在喉部两侧爆裂 研究了在句子产生过程中的患者之前，以及几个 周数 术后，单侧甲状旁腺肉毒毒素注射。这个 水准仪 两组患者的肌肉张力和肌肉爆发率均显著降低 喉两侧的甲状旁肌和环甲肌 表明参与症状的中枢机制 世代 在注射肉毒杆菌毒素后发生改变。

Studies of neurotransmitters involved in the laryngeal sensori-motor pathways are being conducted. The regions in the medulla previously identified as functionally involved in the laryngeal glottic closure reflex were studied to determine which excitatory amino acid receptors play a role in this reflex. The distribution of AMPA-selective glutamate receptor subunits (GluR1-GluR4) and the NMDA receptor subunit NMDAR1 were also studied. Staining for all the antibodies were found in the nucleus tractus solitarius. However, the concentration of GluR1 was significantly greater than NMDAR1 or GluR4 in the interstitial subnucleus, a region previously found associated with laryngeal closure reflex responses. A study was also completed which examined the pattern of muscle activity in the thyroarytenoid muscle in patients with vocal fold paralysis either of idiopathic origin or following nerve injury. All patients had persistent paralysis with thyroarytenoid muscle reinnervation. To examine for evidence of synkinesis, bipolar electrode recordings were made of thyroarytenoid muscle activation during respiration and phonation. In all but one patient muscle activation was normal in amplitude and pattern of activation for respiration and phonation. These results suggest that the thyroarytenoid muscle was not affected by synkinesis. Other muscles and joint fixation need to be evaluated to determine the basis for the persistent paralysis despite reinnervation. To evaluate changes in pathophysiology following botulinum toxin injection in patients with adductor spasmodic dysphonia, thyroarytenoid and cricothyroid muscle bursting on both sides of the larynx were studied during sentence production in patients before, and several weeks after, unilateral thyroarytenoid botulinum toxin injection. The levels of muscle tone and muscle bursts were significantly reduced in both thyroarytenoid and cricothyroid muscles on both sides of the larynx indicating that the central mechanisms involved in symptom generation were altered following botulinum toxin injection.