Connective Tissues as a Factor in Vocal Fold Paralysis

描述(由申请人提供)：本研究的目标是 探讨喉返神经的“包装”和血管供应 迷走神经分支(RLN)与单侧发声的关系 褶皱麻痹(UVP)。声带对于保护儿童的健康非常重要 吞咽时和发声时的呼吸道。患有UVP的个人， 因此，经常会在进食时窒息，难以入睡 说话时听到的声音。UVP的发生率随着年龄的增长而增加，发生的更多 通常位于左侧，最常与手术损伤有关， 肿瘤肿块，以及损害RLN功能的病毒感染。在大约 L6-31%的UVP病例为特发性麻痹。这项研究 在本申请中提出的将解决可能的结缔组织因子 这可能解释了UVP，特别是在患有特发性和 手术后的病因。具体地说，这项研究将描述规模 以及围绕RLN神经束的“包装”或外膜的组成 在年轻和衰老的成人身体上，并与以前 使用狗进行研究的结果。这项研究还将表征 人类喉返神经的血管供应。从这项研究中获得的知识将 提供对RLN对缺血的易感性的洞察 压缩或拉伸。这项研究的发现可能会导致新的外科手术 保护RLN不受影响的程序的方法 咽部、气管、甲状腺、食道、肺和心脏。此外, 识别保护神经“包装”中与年龄相关的差异 血管供应可能阐明可能与发病相关的组织因子 特发性UVP用于未来的解剖和生理研究 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.