Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome [v1; ref status: indexed, http://f1000r.es/Sh1pwj]
Objective: Phrenic nerve pacing can be used to treat congenital central hypoventilation syndrome (CCHS). We report how the lack of normal vocal cord tone during phrenic paced respiration can result in passive vocal cord collapse and produce obstructive symptoms. Methods: We describe a case of passiv...
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2012-11-01
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| Series: | F1000Research |
| Subjects: | |
| Online Access: | http://f1000research.com/articles/1-42/v1 |
| _version_ | 1818368959456477184 |
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| author | Mark C Domanski Diego A Preciado |
| author_facet | Mark C Domanski Diego A Preciado |
| author_sort | Mark C Domanski |
| collection | DOAJ |
| description | Objective: Phrenic nerve pacing can be used to treat congenital central hypoventilation syndrome (CCHS). We report how the lack of normal vocal cord tone during phrenic paced respiration can result in passive vocal cord collapse and produce obstructive symptoms. Methods: We describe a case of passive vocal cord collapse during phrenic nerve paced respiration in a patient with CCHS. As far as we know, this is the first report of this etiology of airway obstruction. The patient, a 7-year-old with CCHS and normal waking vocal cord movement, continued to require nightly continuous positive airway pressure (CPAP) despite successful utilization of phrenic nerve pacers. On direct laryngoscopy, the patient’s larynx was observed while the diaphragmatic pacers were sequentially engaged. Results: No abnormal vocal cord stimulation was witnessed during engaging of either phrenic nerve stimulator. However, the lack of normal inspiratory vocal cord abduction during phrenic nerve-paced respiration resulted in vocal cord collapse and partial obstruction due to passive adduction of the vocal cords through the Bernoulli effect. Bilateral phrenic nerve stimulation resulted in more vocal cord collapse than unilateral stimulation. Conclusions: The lack of vocal cord abduction on inspiration presents a limit to phrenic nerve pacers. |
| first_indexed | 2024-12-13T23:16:14Z |
| format | Article |
| id | doaj.art-d7d2433fe145403a94cd109443d9bc01 |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-12-13T23:16:14Z |
| publishDate | 2012-11-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-d7d2433fe145403a94cd109443d9bc012022-12-21T23:27:56ZengF1000 Research LtdF1000Research2046-14022012-11-01110.12688/f1000research.1-42.v1211Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome [v1; ref status: indexed, http://f1000r.es/Sh1pwj]Mark C Domanski0Diego A Preciado1Department of Surgery, University of Mississippi, Jackson, MS, 39216, USADepartment of Otolaryngology, Children’s National Medical Center, Washington, D.C., 20010-2970, USAObjective: Phrenic nerve pacing can be used to treat congenital central hypoventilation syndrome (CCHS). We report how the lack of normal vocal cord tone during phrenic paced respiration can result in passive vocal cord collapse and produce obstructive symptoms. Methods: We describe a case of passive vocal cord collapse during phrenic nerve paced respiration in a patient with CCHS. As far as we know, this is the first report of this etiology of airway obstruction. The patient, a 7-year-old with CCHS and normal waking vocal cord movement, continued to require nightly continuous positive airway pressure (CPAP) despite successful utilization of phrenic nerve pacers. On direct laryngoscopy, the patient’s larynx was observed while the diaphragmatic pacers were sequentially engaged. Results: No abnormal vocal cord stimulation was witnessed during engaging of either phrenic nerve stimulator. However, the lack of normal inspiratory vocal cord abduction during phrenic nerve-paced respiration resulted in vocal cord collapse and partial obstruction due to passive adduction of the vocal cords through the Bernoulli effect. Bilateral phrenic nerve stimulation resulted in more vocal cord collapse than unilateral stimulation. Conclusions: The lack of vocal cord abduction on inspiration presents a limit to phrenic nerve pacers.http://f1000research.com/articles/1-42/v1Laryngology/Phonosurgery/Speech EvaluationPediatric OtolaryngologyRespiratory PediatricsSleep & Ventilation Disorders |
| spellingShingle | Mark C Domanski Diego A Preciado Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome [v1; ref status: indexed, http://f1000r.es/Sh1pwj] F1000Research Laryngology/Phonosurgery/Speech Evaluation Pediatric Otolaryngology Respiratory Pediatrics Sleep & Ventilation Disorders |
| title | Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome [v1; ref status: indexed, http://f1000r.es/Sh1pwj] |
| title_full | Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome [v1; ref status: indexed, http://f1000r.es/Sh1pwj] |
| title_fullStr | Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome [v1; ref status: indexed, http://f1000r.es/Sh1pwj] |
| title_full_unstemmed | Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome [v1; ref status: indexed, http://f1000r.es/Sh1pwj] |
| title_short | Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome [v1; ref status: indexed, http://f1000r.es/Sh1pwj] |
| title_sort | vocal cord collapse during phrenic nerve paced respiration in congenital central hypoventilation syndrome v1 ref status indexed http f1000r es sh1pwj |
| topic | Laryngology/Phonosurgery/Speech Evaluation Pediatric Otolaryngology Respiratory Pediatrics Sleep & Ventilation Disorders |
| url | http://f1000research.com/articles/1-42/v1 |
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