Recurrent laryngeal nerve connective tissues as a factor in vocal fold paralysis

喉返神经结缔组织是声带麻痹的一个因素

• 批准号: 8827613
• 负责人: Julie M Barkmeier-Kraemer
• 金额: $ 55.97万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-13 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8827613
• 关键词: Adipose tissue; Adolescent; Adult; Age; Age-Years; Aging; Aneurysm; Animal Model; Animals; Aorta; Biomechanics; Breathing; Caliber; Characteristics; Chest; Choking; Chronic; Collagen; Computer Simulation; Connective Tissue; Deglutition; Diagnosis; Eating; Elderly; Elements; Equus caballus; Etiology; Exhibits; Family suidae; Fascicle; Future; Goals; Human; Impairment; Individual; Inferior; Investigation; Larynx; Left; Location; Longevity; Magnetic Resonance Imaging; Measurable; Measures; Modeling; Neck; Nerve; Nerve Tissue; Operative Surgical Procedures; Outcome; Outcomes Research; Paralysed; Paresis; Patients; Pattern; Peripheral Nerves; Physiological; Play; Population; Production; Property; Pulmonary artery structure; Recurrence; Recurrent Laryngeal Nerve; Regulation; Research; Role; Sampling; Side; Stress; Stretching; Testing; Tissues; Trachea; Vagus nerve structure; Voice; Work; age effect; age related; aortic arch; daily functioning; experience; middle age; model development; response; simulation; theories; vocal cord; young adult

DESCRIPTION (provided by applicant): The goal of this research is to develop a computational model of the biomechanical properties of the "packaging," or connective tissues of the recurrent laryngeal branch (RLN) of the vagus nerve to formulate their role in the onset of unilateral vocal fold paralysis (UVP). The vocal folds are important for protection of the airway during swallowing, the regulation of breathing, and for voice production. Individuals with UVP frequently experience choking while eating, difficulty breathing, and difficulty speaking. The majority of individuals diagnosed with UVP are older than 45 years of age. The most common onset of UVP occurs related to surgery with the second most common onset (12-42%) having no known cause (i.e. idiopathic). Surgical etiology of UVP is associated with nerve or nerve tissue damage suffered during or possibly after surgery. Previous work studying idiopathic onset of UVP in horses suggested that chronic compression to the RLN occurred near the aortic arch or inferior trachea. In fact, recent research has shown that individuals with idiopathic UVP may have damage to the RLN at the level of the aortic arch related to a thoracic aneurysm. An aneurysm, or alternatively, increased aortic compliance, would impose increased stretch and compression to the RLN where it is adjacent to the aorta that can impair nerve function. Our recent studies have found differences in the composition of the RLN connective tissues between its location within the neck bilaterally and the portion of the left RLN within the thorax, including the aortic arch region. These findings support Sunderland's theory that connective tissue patterns within peripheral nerves may develop in response to environmental forces to which the nerve is exposed. In addition, differences in the quantity and composition of the RLN were demonstrated between piglets and young adult pigs and between middle age adults and elderly humans indicating that connective tissue changes continue with aging. Given that UVP occurs more often in older than younger humans and animals suggests the need to consider age-related connective tissue changes as a potential contributing factor. The purpose of the proposed research is to develop a computational model of RLN connective tissues that will be used to test for differences in forces imposed on the RLN in subjects with and without UVP. This model will also be used to conduct simulations to predict the degree of stretch or compression necessary to cause damage to RLN connective tissues leading to nerve impairment such as might occur related to the surgical etiology. Development of this model using both pig and human RLN tissues allows for comparison of the similarities and differences between these species so that outcomes from future investigation of predicted levels of RLN tissue deformation necessary to cause onset of UVP using a pig model can be generalized to people.

描述（由申请人提供）：这项研究的目的是开发一个“包装”的生物力学特性的计算模型，或迷走神经的复发性喉部分支（RLN）的结缔组织，以制定其在单方面声音折叠瘫痪（UVP）的发作中的作用。声带对于在吞咽，呼吸调节和语音产生过程中保护气道非常重要。患有UVP的人在进食，呼吸困难和说话困难时经常会经历窒息。大多数被诊断出患有UVP的人年龄在45岁以上。 UVP的最常见发作是与手术有关的，第二大常见的发作（12-42％）没有已知原因（即特发性）。 UVP的手术病因与手术后或可能在手术后或可能遭受的神经或神经组织损伤有关。先前研究马匹UVP特发性发作的工作表明，对RLN的慢性压缩发生在主动脉弓或下气管附近。实际上，最近的研究表明，具有特发性UVP的个体可能会损害与胸部动脉瘤有关的主动脉弓级别的RLN。动脉瘤或增加主动脉瘤的依从性会增加拉伸和压缩的RLN，与主动脉相邻的RLN可能会损害神经功能。我们最近的研究发现，RLN结缔组织的组成差异是双侧双侧和胸腔内左RLN部分（包括主动脉弓区域）之间的位置之间的差异。这些发现支持桑德兰的理论，即外周神经内的结缔组织模式可能会响应神经暴露的环境力而发展。此外，在小猪和年轻猪之间以及中年成年人和老年人之间证明了RLN的数量和组成差异，表明结缔组织的变化随着衰老而持续。鉴于UVP在年龄较大的人中更频繁地发生，而动物表明有必要将与年龄相关的结缔组织变化视为潜在的促成因素。拟议的研究的目的是开发RLN结缔组织的计算模型，该模型将用于测试有或没有UVP受试者对RLN施加的力的差异。该模型还将用于进行模拟，以预测导致RLN结缔组织损害导致神经障碍的损害所需的拉伸或压缩程度，例如可能与外科病因有关。使用猪和人类RLN组织对该模型的开发可以比较这些物种之间的相似性和差异，从而使未来研究预测水平的RLN组织变形的结果可以推广到人们使用猪模型。