laryngeal spasm and sleep

Intermittent vagus nerve stimulation can reduce the frequency of seizures in patients with refractory epilepsy. Stimulation of vagus nerve afferent fibers can also cause vocal cord dysfunction, laryngeal spasm, cough, dyspnea, nausea, and vomiting. Vagus nerve stimulation causes an increase in respiratory rate, decrease in respiratory amplitude, decrease in tidal volume, and decrease in oxygen saturation during periods of device activation. It usually does not cause an arousal, or a change in heart rate or blood pressure...

Idiopathic laryngeal spasm (ILS) is an uncommon disorder characterised by brief episodes of stridor, occurring at any time. Subsequent outpatient ENT examination is normal. These episodes cause considerable anxiety for both patient and physician. Little is known about the initiating event(s) in this condition or the long-term outcome. Using a combination of telephone and postal questionnaires with case note review, we have reviewed a cohort of 21 patients with this diagnosis managed by the senior author over the last 15 years...

OBJECTIVE: Experiences and lessons of uvulopalatopharyngoplasty (UPPP ) perioperative management, especially causes of postoperative tracheotomy, were analyzed, and related strategy was raised to have a better perioperative management and to avoid tracheotomy. METHODS: Two hundred and fifty eight cases of obstructive sleep apnea hypopnea syndromes (OSAHS) diagnosed with polysomnography (PSG) were treated with modified uvulopalatopharyngoplasty (UPPP). The perioperative management was summarized...

A rare case of idiopathic laryngeal spasm presented itself as sleep apnea in a middle-aged man. A tracheostomy followed by the division of the recurrent laryngeal nerve relieved all of the symptoms.

The upper airways are a complex structure with multiple functions; many of the muscles participate in the act of respiration. The neural control of upper airway muscles is distinct from that of chest wall muscles under a variety of circumstances. Coordinated activation of upper airway muscles, both regionally and inter-regionally, results in changes in upper airway size and resistance, alterations in the route of airflow, and increases in the ability of the airways to resist collapse. Several disorders have now been described in which neuromuscular drive abnormalities and/or mechanical dysfunction of the upper airways occur, resulting in clinical disease...

Cine CT, with its very rapid imaging capabilities, was used to evaluate eight adult patients suspected of nonfixed upper airway obstruction. A method was developed for such imaging, which provides 10 images at each of 12 contiguous levels, extending from the soft palate through the extrathoracic trachea. These give a dynamic view of the airway during at least one full respiratory cycle and take about 6 sec to obtain. Results were compared with similar studies in 10 normal volunteers. Seven of the patients showed intermittent obstruction on cine CT, while the eighth was judged normal...

This paper discusses the personal criteria followed in indicating tonsillectomy and/or adenotonsillectomy in treating a group of 150 children between the ages of 2 and 12 in the ENT Department of the Crobu Hospital of Iglesias where a follow-up was carried out from May 1989 to March 1991. The study analyzes when and under what conditions these surgical procedures are indicated in young patients without recurrent tonsillitis but with obstructive sleep apnea (OSA). The utility of traditional laboratory investigations (such as surface pharyngeal swabbing) in indicating surgical therapy is also evaluated...