Graduate Program in Speech-Language Pathology, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, South Korea 03722.
Department of Physiological Sciences, University of Florida, 1333 Center Drive, Gainesville, FL 32610, USA.
Respir Physiol Neurobiol. 2023 May;311:104033. doi: 10.1016/j.resp.2023.104033. Epub 2023 Feb 9.
Glottal closure has been considered as the primary constriction point during the compression phase (CP); however, vocal fold adduction alone cannot resist the high pressures, providing motivation to explore other mechanisms contributing to that resistance. The goal of this study was to identify site(s) and degree of constriction during the CP of cough of varying types in healthy young adults. Twenty-five healthy young participants participated in this study. The experimental protocol was comprised of: 1) baseline pulmonary function measures; 2) cough practice to establish weak, moderate and strong coughs; 3) voluntary and reflex cough assessments with fluoroscopy and airflow measures. We used a repeated measures ANOVA to identify whether there are differences in constriction ratio between cough types. There was a significant difference in constriction of varying cough types. Degree of constriction in all cough strengths showed that the glottis was the most constricted area, followed by the laryngeal vestibule, nasopharynx, hypopharynx, oropharynx, and cervical trachea, in order, but stronger cough resulted in more constriction in all areas compared to weaker cough. Degree of constriction in reflex cough showed a similar pattern though there was greater constriction in the oropharynx than the hypopharynx. Airflow measures in voluntary cough were consistent with previous findings. Differences in upper airway constriction during the compression phase of cough may be attributed to differences in motor control between reflex and voluntary cough, and the increased constriction seen during strong cough may reflect increased muscle recruitment during that task. In the future, we can use this knowledge to develop novel methods for cough rehabilitation.
声门闭合被认为是压缩阶段（CP）的主要狭窄点；然而，声带内收本身无法抵抗高压，这促使我们探索其他有助于抵抗高压的机制。本研究的目的是确定健康年轻成年人不同类型咳嗽的 CP 期间狭窄部位和狭窄程度。25 名健康年轻参与者参加了这项研究。实验方案包括：1）基线肺功能测量；2）咳嗽练习以建立弱、中、强咳嗽；3）使用透视和气流测量进行自愿和反射咳嗽评估。我们使用重复测量方差分析来确定咳嗽类型之间的收缩比是否存在差异。不同咳嗽类型的收缩存在显著差异。所有咳嗽强度的收缩程度表明，声带是最狭窄的区域，其次是喉前庭、鼻咽、下咽、口咽和颈气管，但与弱咳嗽相比，强咳嗽导致所有区域的收缩程度更大。反射咳嗽的收缩程度表现出相似的模式，尽管口咽的收缩程度大于下咽。自愿咳嗽的气流测量与先前的发现一致。咳嗽 CP 期间上呼吸道狭窄程度的差异可能归因于反射咳嗽和自愿咳嗽之间的运动控制差异，以及在强咳嗽期间观察到的收缩增加可能反映了该任务中肌肉募集的增加。在未来，我们可以利用这些知识开发新型咳嗽康复方法。
