Exploring the relationship between plasma substance P and glottal incompetence in the elderly
Koichi Tsunoda,
Toyota Ishii,
Hiroyuki Kuroda,
Hiroaki Nakatani,
Masaru Tateda,
Sawako Masuda,
Tetsuya Takiguchi,
Fujinobu Tanaka,
Hayato Misawa,
Masamitsu Senarita,
Mihiro Takazawa,
Kenji Itoh,
Thomas Baer
Affiliations
Koichi Tsunoda
Department of Otolaryngology, NHO (National Hospital Organization) Tokyo Medical Center, Tokyo, Japan; Department of Artificial Organs & Medical Creations, NHO (National Hospital Organization) Tokyo Medical Center, Tokyo, Japan; Corresponding author. Chairman of Artificial Organs & Medical Creations, Department of Otolaryngology NHO (National Hospital Organization) Tokyo Medical Center 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
Toyota Ishii
Department of Otolaryngology, NHO (National Hospital Organization) Sagamihara Hospital, Kanagawa, Japan
Hiroyuki Kuroda
Department of Otolaryngology, NHO (National Hospital Organization) Kobe Medical Center, Hyogo, Japan
Hiroaki Nakatani
Department of Otolaryngology, NHO (National Hospital Organization) Fukuyama Medical Center, Hiroshima, Japan
Masaru Tateda
Department of Otolaryngology, NHO (National Hospital Organization) Sendai Medical Center, Miyagi, Japan
Sawako Masuda
Department of Otolaryngology, NHO (National Hospital Organization) Mie Hospital, Mie, Japan
Tetsuya Takiguchi
Department of Otolaryngology, NHO (National Hospital Organization) Kanazawa Medical Center, Ishikawa, Japan
Fujinobu Tanaka
Department of Otolaryngology, NHO (National Hospital Organization) Nagasaki Medical Center, Nagasaki, Japan
Hayato Misawa
Department of Otolaryngology, NHO (National Hospital Organization) Nagoya Medical Center, Aichi, Japan
Masamitsu Senarita
Department of Otolaryngology, NHO (National Hospital Organization) Mito Medical Center, Ibaraki, Japan
Mihiro Takazawa
Department of Artificial Organs & Medical Creations, NHO (National Hospital Organization) Tokyo Medical Center, Tokyo, Japan
Kenji Itoh
Department of Artificial Organs & Medical Creations, NHO (National Hospital Organization) Tokyo Medical Center, Tokyo, Japan
We speculated that increased blood-plasma levels of Substance P may serve as an indicator of glottal incompetence, which is usually indicated by reduced maximum phonation time. We performed an initial study to test the plausibility of this hypothesis. Patients with dysphonia caused by glottal incompetence were asked to perform vocal exercises for six months to reduce glottal incompetence and we compared the plasma concentration of Substance P before and after the vocal exercise to detect correlation between maximum phonation time and plasma concentration of Substance P. Based on the results, we further hypothesized that patients exhibiting dysphonia with maximum phonation time less than 14 s, in particular less than 10 sec, caused by glottal incompetence may have increased plasma concentration of Substance P with the results of elevated thresholds of cough reflex associated with subclinical aspiration in airways. Further study is needed on patients with decreased Substance P levels, with low scores on Activities of Daily Living and who are hospitalized with aspiration pneumonia.
