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Coughing in laryngectomized patients.
G A Fontana1, T Pantaleo, F Lavorini
1Dipartimento di Fisiopatologia Clinica, Sezione di Fisiopatologia Respiratoria; Dipartimento di Scienze Fisiologiche and Clinica Otorinolaringoiatrica, Università di Firenze, Florence, Italy. g.fontana@dfc.unifi.it
American Journal of Respiratory and Critical Care Medicine
|November 11, 1999
Summary
Laryngectomy reduces cough intensity and cough volume acceleration, potentially increasing chest infection risk in patients. This study investigated cough reflex and voluntary cough in patients after larynx removal.
Area of Science:
- Respiratory Physiology
- Surgical Outcomes
- Clinical Investigation
Background:
- Laryngectomy removes laryngeal afferent information crucial for expiratory control and airway reflexes like coughing.
- Understanding the impact of laryngectomy on cough mechanics is vital for managing post-surgical complications.
Purpose of the Study:
- To assess the effects of laryngectomy on the sensory and motor components of both voluntary and reflex coughing.
- To determine if laryngeal denervation alters cough intensity, flow, and acceleration.
Main Methods:
- Compared maximal voluntary cough (MVC) and reflex cough (RC) responses in 10 laryngectomized patients and 10 controls.
- Analyzed cough intensity via integrated electromyographic activity of abdominal muscles (IEMGP) and cough peak flow.
- Assessed cough threshold and suprathreshold responses to inhaled distilled water fog.
Main Results:
- Cough threshold was similar between groups.
- Laryngectomized patients showed reduced IEMGP and IEMGP/TEC during reflex cough at suprathreshold (RCT) levels.
- Cough volume acceleration was significantly reduced in patients, particularly during RCT.
Conclusions:
- Laryngeal denervation following laryngectomy impairs cough motor output and volume acceleration.
- These deficits may contribute to increased susceptibility to chest infections in laryngectomized individuals.