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Active upper airway closure during induced central apneas in lambs is complete at the laryngeal level only

¹Pulmonary Research Unit, ²Ear, Nose, and Throat Division, Department of Surgery, and ³Departments of Pediatrics and Physiology, University of Sherbrooke, Quebec, Canada J1H 5N4

Submitted 23 August 2002 ; accepted in final form 3 March 2003

We tested the hypotheses that active upper airway closure during induced central apneas in nonsedated lambs 1) is complete and occurs at the laryngeal level and 2) is not due to stimulation of the superior laryngeal nerves (SLN). Five newborn lambs were surgically instrumented to record thyroarytenoid (TA) muscle (glottal constrictor) electromyographic (EMG) activity with supra- and subglottal pressures. Hypocapnic and nonhypocapnic central apneas were induced before and after SLN sectioning in the five lambs. A total of 174 apneas were induced, 116 before and 58 after sectioning of the internal branch of the SLN (iSLN). Continuous TA EMG activity was observed in 88% of apneas before iSLN section and in 87% of apneas after iSLN section. A transglottal pressure different from zero was observed in all apneas with TA EMG activity, with a mean subglottal pressure of 4.3 ± 0.8 cmH₂O before and 4.7 ± 0.7 cmH₂O after iSLN section. Supraglottal pressure was consistently atmospheric. Sectioning of both iSLNs had no effects on the results. We conclude that upper airway closure during induced central apneas in lambs is active, complete, and occurs at the glottal level only. Consequently, a positive subglottal pressure is maintained throughout the apnea. Finally, this complete active glottal closure is independent from laryngeal afferent innervation.

newborn; thyroarytenoid muscle; transglottal pressure; transpharyngeal pressure; superior laryngeal nerve

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