A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis

Megan J. Williams, Avinash Ayylasomayajula, Reza Behkam, Andrew J. Bierhals, M. Eileen Jacobs, Julia D. Edgar, Randal C. Paniello, Julie M. Barkmeier-Kraemer, Jonathan P. Vande Geest

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Unilateral vocal-fold paralysis (UVP) occurs when one of the vocal folds becomes paralyzed due to damage to the recurrent laryngeal nerve (RLN). Individuals with UVP experience problems with speaking, swallowing, and breathing. Nearly two-thirds of all cases of UVP is associated with impaired function of the left RLN, which branches from the vagus nerve within the thoracic cavity and loops around the aorta before ascending to the larynx within the neck. We hypothesize that this path predisposes the left RLN to a supraphysiological, biomechanical environment, contributing to onset of UVP. Specifically, this research focuses on the identification of the contribution of the aorta to onset of left-sided UVP. Important to this goal is determining the relative influence of the material properties of the RLN and the aorta in controlling the biomechanical environment of the RLN. Finite element analysis was used to estimate the stress and strain imposed on the left RLN as a function of the material properties and loading conditions. The peak stress and strain in the RLN were quantified as a function of RLN and aortic material properties and aortic blood pressure using Spearman rank correlation coefficients. The material properties of the aortic arch showed the strongest correlation with peak stress [ρ = -0.63, 95% confidence interval (CI), -1.00 to -0.25] and strain (ρ = -0.62, 95% CI, -0.99 to -0.24) in the RLN. Our results suggest an important role for the aorta in controlling the biomechanical environment of the RLN and potentially in the onset of left-sided UVP that is idiopathic.

Original languageEnglish (US)
Pages (from-to)465-474
Number of pages10
JournalJournal of Applied Physiology
Volume118
Issue number4
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Fingerprint

Recurrent Laryngeal Nerve
Vocal Cords
Thoracic Aorta
Paralysis
Aorta
Confidence Intervals
Thoracic Cavity
Finite Element Analysis
Vagus Nerve
Deglutition
Larynx
Nonparametric Statistics
Arterial Pressure
Respiration
Neck

Keywords

  • Biomechanics
  • Finite element
  • Nerve
  • Recurrent laryngeal nerve
  • Vocalfold paralysis

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Williams, M. J., Ayylasomayajula, A., Behkam, R., Bierhals, A. J., Jacobs, M. E., Edgar, J. D., ... Vande Geest, J. P. (2015). A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis. Journal of Applied Physiology, 118(4), 465-474. https://doi.org/10.1152/japplphysiol.00638.2014

A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis. / Williams, Megan J.; Ayylasomayajula, Avinash; Behkam, Reza; Bierhals, Andrew J.; Jacobs, M. Eileen; Edgar, Julia D.; Paniello, Randal C.; Barkmeier-Kraemer, Julie M.; Vande Geest, Jonathan P.

In: Journal of Applied Physiology, Vol. 118, No. 4, 01.02.2015, p. 465-474.

Research output: Contribution to journalArticle

Williams, MJ, Ayylasomayajula, A, Behkam, R, Bierhals, AJ, Jacobs, ME, Edgar, JD, Paniello, RC, Barkmeier-Kraemer, JM & Vande Geest, JP 2015, 'A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis', Journal of Applied Physiology, vol. 118, no. 4, pp. 465-474. https://doi.org/10.1152/japplphysiol.00638.2014
Williams, Megan J. ; Ayylasomayajula, Avinash ; Behkam, Reza ; Bierhals, Andrew J. ; Jacobs, M. Eileen ; Edgar, Julia D. ; Paniello, Randal C. ; Barkmeier-Kraemer, Julie M. ; Vande Geest, Jonathan P. / A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis. In: Journal of Applied Physiology. 2015 ; Vol. 118, No. 4. pp. 465-474.
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