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Relationship between thyroarytenoid activity and laryngeal resistance
Authors:A Tully  A Brancatisano  S H Loring  L A Engel
Institution:Thoracic Medicine Unit, Westmead Hospital, Sydney, New South Wales, Australia.
Abstract:We examined the relationship between subglottic pressure (P), flow (V), and thyroarytenoid (TA) muscle activity in six anesthetized tracheostomized dogs while a constant flow (0.05-1.2 l/s) of warmed humidified air was passed through the upper airway in an expiratory direction. The TA activity was recorded by fine bipolar wire electrodes and was reflexly altered by changes in lung volume and chest wall compression. The integrated muscle activity was expressed as a percentage of a maximal peak integrated TA activity (%max). In the absence of TA activity the pressure-flow relationship was alinear and could be described by a power function. Log-log P-V plots at varying levels of TA activity were linear, with a slope a of 1.84 +/- 0.07 (SD). When TA activity increased, laryngeal resistance increased exponentially. An effective hydraulic diameter was calculated for increments in %max TA and decreased linearly with %max TA. In three dogs the glottic diameter was computed from glottic area measured by fiber-optic laryngoscopy, and it also decreased linearly as TA increased. Sectioning of the external motor branch of the superior laryngeal nerve to the cricothyroid muscle demonstrated no consistent effect on laryngeal resistance over a range of TA activity. The results indicate that laryngeal dimensions decrease linearly with TA activity. However, the P-V relationship of the larynx may be described by a power function, with a single exponent consistent with an orifice flow regimen. Spontaneous activity of the cricothyroid muscle does not measurably influence this relationship.
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