Tremulous arytenoid movements predict severity of glottic stenosis in multiple system atrophy.
Identifieur interne : 002B37 ( Ncbi/Curation ); précédent : 002B36; suivant : 002B38Tremulous arytenoid movements predict severity of glottic stenosis in multiple system atrophy.
Auteurs : Tetsutaro Ozawa [Japon] ; Hideo Shinoda ; Masahiko Tomita ; Takayoshi Shimohata ; Hideaki Nakayama ; Masatoyo NishizawaSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- Aged, Arytenoid Cartilage (physiopathology), Case-Control Studies, Constriction, Pathologic (diagnosis), Constriction, Pathologic (etiology), Female, Glottis (pathology), Humans, Laryngoscopy (methods), Male, Middle Aged, Multiple System Atrophy (complications), Predictive Value of Tests, Statistics as Topic, Statistics, Nonparametric, Tremor (pathology), Video Recording (methods).
- MESH :
- complications : Multiple System Atrophy.
- diagnosis : Constriction, Pathologic.
- etiology : Constriction, Pathologic.
- methods : Laryngoscopy, Video Recording.
- pathology : Glottis, Tremor.
- physiopathology : Arytenoid Cartilage.
- Aged, Case-Control Studies, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Statistics as Topic, Statistics, Nonparametric.
Abstract
To determine whether tremulous arytenoid movements predict the severity of glottic stenosis in patients with multiple system atrophy (MSA), 28 MSA patients and 14 age-matched controls underwent fiberoptic laryngoscopy with video monitoring during wakefulness and under anesthesia induced by intravenous injection of propofol. Presence or absence of tremulous arytenoid movements was recorded during wakefulness. The ratio of glottic stenosis (%), which represents the extent of airway narrowing under anesthesia, was obtained by measuring the inspiratory glottic angle during wakefulness and under anesthesia. The median ratio of glottic stenosis was significantly higher in patients with MSA (57.5%) than in control subjects (0.5%). Tremulous arytenoid movements were characterized by shaking movements of the arytenoid region including the vocal folds, which are most apparent in the arytenoid cartilage. In this study, tremulous arytenoid movements were observed in 18 (64.2%) of 28 patients with MSA, who displayed a significantly higher median ratio of glottic stenosis (71.2%) than other patients (34.9%). None of the control subjects exhibited tremulous arytenoid movements. A clear correlation existed between the ratio of glottic stenosis and disease duration. Our observations indicate that tremulous arytenoid movements are a marker of the severity of glottic stenosis, which confers an increased risk of upper airway obstruction in patients with MSA.
DOI: 10.1002/mds.23090
PubMed: 20310045
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pubmed:20310045Le document en format XML
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<author><name sortKey="Ozawa, Tetsutaro" sort="Ozawa, Tetsutaro" uniqKey="Ozawa T" first="Tetsutaro" last="Ozawa">Tetsutaro Ozawa</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Niigata University Brain Research Institute, Niigata, Japan. ozawa@bri.niigata-u.ac.jp</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Neurology, Niigata University Brain Research Institute, Niigata</wicri:regionArea>
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<author><name sortKey="Shinoda, Hideo" sort="Shinoda, Hideo" uniqKey="Shinoda H" first="Hideo" last="Shinoda">Hideo Shinoda</name>
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<author><name sortKey="Tomita, Masahiko" sort="Tomita, Masahiko" uniqKey="Tomita M" first="Masahiko" last="Tomita">Masahiko Tomita</name>
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<author><name sortKey="Shimohata, Takayoshi" sort="Shimohata, Takayoshi" uniqKey="Shimohata T" first="Takayoshi" last="Shimohata">Takayoshi Shimohata</name>
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<author><name sortKey="Nakayama, Hideaki" sort="Nakayama, Hideaki" uniqKey="Nakayama H" first="Hideaki" last="Nakayama">Hideaki Nakayama</name>
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<author><name sortKey="Nishizawa, Masatoyo" sort="Nishizawa, Masatoyo" uniqKey="Nishizawa M" first="Masatoyo" last="Nishizawa">Masatoyo Nishizawa</name>
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<author><name sortKey="Shinoda, Hideo" sort="Shinoda, Hideo" uniqKey="Shinoda H" first="Hideo" last="Shinoda">Hideo Shinoda</name>
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<author><name sortKey="Tomita, Masahiko" sort="Tomita, Masahiko" uniqKey="Tomita M" first="Masahiko" last="Tomita">Masahiko Tomita</name>
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<author><name sortKey="Shimohata, Takayoshi" sort="Shimohata, Takayoshi" uniqKey="Shimohata T" first="Takayoshi" last="Shimohata">Takayoshi Shimohata</name>
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<author><name sortKey="Nakayama, Hideaki" sort="Nakayama, Hideaki" uniqKey="Nakayama H" first="Hideaki" last="Nakayama">Hideaki Nakayama</name>
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<author><name sortKey="Nishizawa, Masatoyo" sort="Nishizawa, Masatoyo" uniqKey="Nishizawa M" first="Masatoyo" last="Nishizawa">Masatoyo Nishizawa</name>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
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<term>Arytenoid Cartilage (physiopathology)</term>
<term>Case-Control Studies</term>
<term>Constriction, Pathologic (diagnosis)</term>
<term>Constriction, Pathologic (etiology)</term>
<term>Female</term>
<term>Glottis (pathology)</term>
<term>Humans</term>
<term>Laryngoscopy (methods)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Multiple System Atrophy (complications)</term>
<term>Predictive Value of Tests</term>
<term>Statistics as Topic</term>
<term>Statistics, Nonparametric</term>
<term>Tremor (pathology)</term>
<term>Video Recording (methods)</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Multiple System Atrophy</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Constriction, Pathologic</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Constriction, Pathologic</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Laryngoscopy</term>
<term>Video Recording</term>
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<term>Tremor</term>
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<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
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<front><div type="abstract" xml:lang="en">To determine whether tremulous arytenoid movements predict the severity of glottic stenosis in patients with multiple system atrophy (MSA), 28 MSA patients and 14 age-matched controls underwent fiberoptic laryngoscopy with video monitoring during wakefulness and under anesthesia induced by intravenous injection of propofol. Presence or absence of tremulous arytenoid movements was recorded during wakefulness. The ratio of glottic stenosis (%), which represents the extent of airway narrowing under anesthesia, was obtained by measuring the inspiratory glottic angle during wakefulness and under anesthesia. The median ratio of glottic stenosis was significantly higher in patients with MSA (57.5%) than in control subjects (0.5%). Tremulous arytenoid movements were characterized by shaking movements of the arytenoid region including the vocal folds, which are most apparent in the arytenoid cartilage. In this study, tremulous arytenoid movements were observed in 18 (64.2%) of 28 patients with MSA, who displayed a significantly higher median ratio of glottic stenosis (71.2%) than other patients (34.9%). None of the control subjects exhibited tremulous arytenoid movements. A clear correlation existed between the ratio of glottic stenosis and disease duration. Our observations indicate that tremulous arytenoid movements are a marker of the severity of glottic stenosis, which confers an increased risk of upper airway obstruction in patients with MSA.</div>
</front>
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