Glottic Closure Reflex: Control Mechanisms

Abstract

Reflex glottic closure is a dominant and stable reflex produced by stimulation of the superior laryngeal nerve. Its precise execution is basic to successful sphincteric protection of the lower airway. In exaggerated form, it produces life-threatening laryngospasm. Clearly, reflex glottic closure and laryngospasm are facilitated by: a) expiratory phase; b) decreased arterial partial pressure of carbon dioxide (pCO₂); c) increased arterial partial pressure of oxygen (pO₂); and d) negative intrathoracic pressure. On the other hand, both reflex glottic closure and laryngospasm are inhibited by: a) inspiratory phase; b) increased arterial pCO₂; c) decreased arterial pO₂; and d) positive intrathoracic pressure. A clear understanding of laryngeal adductor control is an essential first step in the therapeutic modification of abnormal laryngeal closure and laryngospasm.

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References

Suzuki

Sasaki

. Laryngeal spasm: A neurophysiologic redefinition. Ann Otol Rhinol Laryngol 1977; 86: 150–8.

Sherrey

Megirian

. Analysis of the respiratory role of intrinsic laryngeal motoneurons of cat. Exp Neurol 1975; 49: 456–65.

Bianoconi

Raschi

. Respiratory control of motoneurons of the recurrent laryngeal nerve and hypocapnic apnoae. Arch Ital Biol 1964; 102: 56–73.

Salmoiraghi

Burns

. Localization and patterns of discharge of the respiratory neurons in brainstem of cat. J Neurophysiol 1960; 23: 2–13.

Miescher-Rusch

. Bemerkungern zur Lehre von den Atembewegungen. Arch Anat Physiol (Leipzig) 1885; 6: 355–80.

Heymans

Bouckaert

Dantrebande

. Sinus carotidien et reflexes respiratoires. Arch Int Pharmacodyn Ther 1930; 39: 400–48.

Chang

. Cortical response to stimulation of medullary pyramid in rabbit. J Neurophysiol 1955; 18: 332–52.

Chang

. Activation of internuncial neurons through collaterals of pyramid fibers at cortical level. J Neurophysiol 1955; 18: 452–71.

Breuer

. Die Selbsteurung der Atmung durch den Nervus Vagus. Sitzungsber Akad Wiss Wien Math Naturwiss Kl Abt 1868; 58: 909–37.

10.

Hering

. Die Selbsteurung der Atmung durch den Nervus Vagus. Sitzungsber Akad Wiss Wien Math Naturwiss Kl Abt 1868; 57: 672–7.

11.

Sasaki

. Development of laryngeal function: Etiological significance in the sudden infant death syndrome. Laryngoscope 1979; 89: 1964–82.