Aortic arch compliance and idiopathic unilateral vocal fold paralysis

Reza Behkam, Kara E. Roberts, Andrew J. Bierhals, M. Eileen Jacobs, Julia D. Edgar, Randal C. Paniello, Gayle Woodson, Jonathan P. Vande Geest, Julie M. Barkmeier-Kraemer

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Unilateral vocal fold paralysis (UVP) occurs related to recurrent laryngeal nerve (RLN) impairment associated with impaired swallowing, voice production, and breathing functions. The majority of UVP cases occur subsequent to surgical intervention with approximately 12-42% having no known cause for the disease (i.e., idiopathic). Approximately two-thirds of those with UVP exhibit left-sided injury with the average onset at ≥50 yr of age in those diagnosed as idiopathic. Given the association between the RLN and the subclavian and aortic arch vessels, we hypothesized that changes in vascular tissues would result in increased aortic compliance in patients with idiopathic left-sided UVP compared with those without UVP. Gated MRI data enabled aortic arch diameter measures normalized to blood pressure across the cardiac cycles to derive aortic arch compliance. Compliance was compared between individuals with left-sided idiopathic UVP and age- and sex-matched normal controls. Three-way factorial ANOVA test showed that aortic arch compliance (P = 0.02) and aortic arch diameter change in one cardiac cycle (P = 0.04) are significantly higher in patients with idiopathic left-sided UVP compared with the controls. As previously demonstrated by other literature, our finding confirmed that compliance decreases with age (P < 0.0001) in both healthy individuals and patients with idiopathic UVP. Future studies will investigate parameters of aortic compliance change as a potential contributor to the onset of left-sided UVP NEW & NOTEWORTHY Unilateral vocal fold paralysis results from impaired function of the recurrent laryngeal nerve (RLN) impacting breathing, swallowing, and voice production. A large proportion of adults suffering from this disorder have an idiopathic etiology (i.e., unknown cause). The current study determined that individuals diagnosed with left-sided idiopathic vocal fold paralysis exhibited significantly greater compliance than age- and sex-matched controls. These seminal findings suggest a link between aortic arch compliance levels and RLN function..

Original languageEnglish
Pages (from-to)303-309
Number of pages7
JournalJournal of Applied Physiology
Volume123
Issue number2
DOIs
StatePublished - Aug 2017

Keywords

  • Aortic arch compliance
  • Image segmentation
  • Recurrent laryngeal nerve
  • Unilateral vocal fold paralysis

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    Behkam, R., Roberts, K. E., Bierhals, A. J., Jacobs, M. E., Edgar, J. D., Paniello, R. C., Woodson, G., Vande Geest, J. P., & Barkmeier-Kraemer, J. M. (2017). Aortic arch compliance and idiopathic unilateral vocal fold paralysis. Journal of Applied Physiology, 123(2), 303-309. https://doi.org/10.1152/japplphysiol.00239.2017