Connective Tissues as a Factor in Vocal Fold Paralysis

描述（由申请人提供）：本研究的目标是 探讨喉返肌的“包装”和血管供应 迷走神经分支（RLN）作为单侧声带麻痹发病的因素 皱褶麻痹（UVP）。声带对于保护 呼吸道在吞咽和产生声音。患有UVP的人， 因此，经常遇到窒息，而吃和困难， 听到说话的时候。UVP的发生率随年龄的增长而增加， 通常在左侧，并且最常与手术损伤相关， 肿瘤块和病毒感染损害喉返神经功能。在大约 在所有UVP病例中，16%-31%的麻痹是自发性的。研究 在本申请中提出的将解决可能的结缔组织因素 这可以解释UVP，特别是在特发性和 术后病因学。具体来说，这项研究将描述大小 以及围绕RLN神经束的“包装”或神经外膜的组成 在年轻和衰老的成年人尸体中， 使用狗的研究结果。这项研究还将描述 人类喉返神经的血管供应从这项研究中获得的知识将 提供了对RLN缺血易感性的深入了解， 压缩或拉伸。这项研究的结果可能会导致新的外科手术 保护喉返神经在手术过程中免受损伤的方法 咽、气管、甲状腺、食道、肺和心脏。此外，本发明还提供了一种方法， 识别与年龄相关的神经保护“包装”差异 和血管供应可以阐明可能与发病相关的组织因素 特发性UVP的未来解剖和生理研究，使用 动物模型

DESCRIPTION (provided by applicant): The goal of this research is to investigate the "packaging" and the vascular supply to the recurrent laryngeal branch (RLN) of the vagus nerve as factors in the onset of unilateral vocal fold paralysis (UVP). The vocal folds are important for protection of the airway during swallowing and for generating voice. Individuals with UVP, therefore, frequently experience choking while eating and difficulty being heard when speaking. The occurrence of UVP increases with age, occurs more frequently on the left side, and is most often associated with surgical injury, tumor mass, and viral infection that impairs RLN function. In approximately l6-3l percent of all UVP cases, onset of paralysis is idiopathic. The research proposed in this application will address possible connective tissue factors that may explain UVP, particularly in individuals with idiopathic and post-surgical etiologies. Specifically, this research will characterize size and makeup of the "packaging," or epineurium, surrounding RLN nerve fascicles in young and senescent adult human cadavers and make comparisons to previous findings from research using dogs. This research also will characterize the vascular supply to the RLN in humans. Knowledge gained from this research will provide insight into the predisposition of the RLN to ischemia during compression or stretching. Findings from this research may lead to new surgical approaches to protect the RLN from damage during procedures affecting the pharynx, trachea, thyroid gland, esophagus, lungs, and heart. In addition, identification of age-related differences in the protective nerve "packaging" and vascular supply may elucidate tissue factors possibly associated with onset of idiopathic UVP for future anatomic and physiologic investigation using an animal model.