help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by FONTANA, G. A.
Right arrow Articles by PISTOLESI, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by FONTANA, G. A.
Right arrow Articles by PISTOLESI, M.

Am. J. Respir. Crit. Care Med., Volume 160, Number 5, November 1999, 1578-1584

Coughing in Laryngectomized Patients

GIOVANNI A. FONTANA, TITO PANTALEO, FEDERICO LAVORINI, DONATELLA MUTOLO, GIANNI POLLI, and MASSIMO PISTOLESI

Dipartimento di Fisiopatologia Clinica, Sezione di Fisiopatologia Respiratoria; Dipartimento di Scienze Fisiologiche and Clinica Otorinolaringoiatrica, Università di Firenze, Florence, Italy

Ablation of the larynx implies withdrawal of afferent information from receptors involved both in the control of expiratory flow and in the genesis of protective airway reflexes including coughing. To investigate the effects of laryngectomy on the sensory and motor component of coughing, maximal voluntary cough (MVC) efforts as well as the reflex cough (RC) responses at threshold (T) and suprathreshold (1.8 × T, ST) levels induced by inhalation of progressively increasing concentrations of ultrasonically nebulized distilled water (fog) were analyzed in 10 laryngectomized patients and 10 control subjects. Cough intensity was indexed in terms of both the peak amplitude of the integrated electromyographic activity of abdominal muscles (IEMGP) and the ratio of IEMGP to the duration of the expiratory ramp (TEC), i.e., the rate of rise of IEMG activity (IEMGP/TEC). Cough peak flow was also recorded. Cough threshold was similar in patients and controls, as were IEMGP, TEC, and IEMGP/ TEC recorded during MVC and RCST. In contrast, during RCT, patients' IEMGP was significantly reduced (p < 0.05), thus leading to a significant decrease in IEMGP/TEC (p < 0.05) even in the absence of significant differences in TEC. Cough flow closely correlated with IEMG-related variables. Cough volume acceleration, i.e., the ratio of cough peak flow to the corresponding time to cough peak flow was also significantly reduced in the patients, especially during RCT (p < 0.01). The results suggest that the lack of signals arising from the larynx may result in a reduction of cough volume acceleration as well as in the intensity of abdominal muscle contractions during RCT. These factors may contribute to facilitate the onset and/or the persistence of chest infections in laryngectomized patients. Fontana GA, Pantaleo T, Lavorini F, Mutolo D, Polli G, Pistolesi M. Coughing in laryngectomized patients.




This article has been cited by other articles:


Home page
 ChestHome page
C. A. Smith Hammond, L. B. Goldstein, R. D. Horner, J. Ying, L. Gray, L. Gonzalez-Rothi, and D. C. Bolser
Predicting Aspiration in Patients With Ischemic Stroke: Comparison of Clinical Signs and Aerodynamic Measures of Voluntary Cough
Chest, March 1, 2009; 135(3): 769 - 777.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. E. N. Rees, L. Pazmany, D. Gutowska-Owsiak, C. F. Inman, A. Phillips, C. R. Stokes, N. Johnston, J. A. Koufman, G. Postma, M. Bailey, et al.
The Mucosal Immune Response to Laryngopharyngeal Reflux
Am. J. Respir. Crit. Care Med., June 1, 2008; 177(11): 1187 - 1193.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. Lavorini, G. A. Fontana, T. Pantaleo, P. Geri, R. Piumelli, M. Pistolesi, and J. Widdicombe
Fog-induced Cough with Impaired Respiratory Sensation in Congenital Central Hypoventilation Syndrome
Am. J. Respir. Crit. Care Med., October 15, 2007; 176(8): 825 - 832.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A. H. Morice, G. A. Fontana, M. G. Belvisi, S. S. Birring, K. F. Chung, P. V. Dicpinigaitis, J. A. Kastelik, L. P. McGarvey, J. A. Smith, M. Tatar, et al.
ERS guidelines on the assessment of cough
Eur. Respir. J., June 1, 2007; 29(6): 1256 - 1276.
[Full Text] [PDF]

Home page
 ChestHome page
C. A. Smith Hammond and L. B. Goldstein
Cough and Aspiration of Food and Liquids Due to Oral-Pharyngeal Dysphagia: ACCP Evidence-Based Clinical Practice Guidelines
Chest, January 1, 2006; 129(1_suppl): 154S - 168S.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A. H. Morice
From the author
Eur. Respir. J., January 1, 2005; 25(1): 211 - 211.
[Full Text] [PDF]

Home page
 ChestHome page
A. Watando, S. Ebihara, T. Ebihara, T. Okazaki, H. Takahashi, M. Asada, and H. Sasaki
Daily Oral Care and Cough Reflex Sensitivity in Elderly Nursing Home Patients
Chest, October 1, 2004; 126(4): 1066 - 1070.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. LAVORINI, G. A. FONTANA, T. PANTALEO, G. CAMICIOTTOLI, W. CASTELLANI, N. M. MALUCCIO, and M. PISTOLESI
Fog-induced Respiratory Responses Are Attenuated by Nedocromil Sodium in Humans
Am. J. Respir. Crit. Care Med., April 1, 2001; 163(5): 1117 - 1120.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1999 American Thoracic Society 		  CCM abstracts