# Vascular Connective Tissues as a Factor in onset of Idiopathic Vocal Fold Paralysis

> **NIH NIH R01** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2021 · $479,050

## Abstract

PROJECT SUMMARY / ABSTRACT: The goal of this research is to systematically investigate the
contribution of the compliance levels of the aortic arch and pulmonary artery to onset of impaired function of
the recurrent laryngeal branch (RLN) of the vagus nerve associated with unilateral vocal fold paralysis (UVP).
The RLN provides sensorimotor innervation to the muscles that control the vocal folds within the larynx. Vocal
fold function is important for protection of the airway during swallowing, the regulation of breathing, and for
voice production. Individuals with UVP frequently experience choking while eating, difficulty breathing, and
difficulty speaking. The majority of individuals diagnosed with UVP are older than 45 years of age. Although
surgery is the most common etiology of UVP, approximately 12-42% of those diagnosed with UVP have no
known cause (i.e. idiopathic). Prior work studying idiopathic onset of UVP in horses identified nerve changes
and characteristics indicative of chronic compression on the RLN near the aortic arch. Our team recently
identified that individuals with iUVP exhibited significantly higher aortic arch compliance than age- and
gender-matched controls as a possible contributing factor in iUVP. This finding supported our hypothesis that
RLN stress and strain levels associated with aortic arch dynamic diameter changes could impact RLN function.
Similar patterns in pulmonary artery compliance levels were also identified in the same group of those with
iUVP compared to normal controls suggesting a systemic change in vascular compliance. Given that the left
RLN is most commonly associated with iUVP, we hypothesize that increased compliance levels in large-
diameter blood vessels adjacent to the RLN (i.e. aortic arch and pulmonary artery) can impair RLN function
due to excessive stress and strain levels that compromise the nerve's protective layers of connective tissues
resulting in damaged nerve fibers. The goal of this project is to investigate the level of compliance change in
the aorta associated with impaired RLN function in pigs. We will also expand imaging of the aortic arch and
pulmonary artery to include the right subclavian artery to determine whether vascular compliance levels
generally differ between those with iUVP compared to controls. In addition, we will compare compliance levels
between a large-diameter vessel (aortic arch) and a small-diameter vessel (right subclavian artery) associated
with the RLN between human subjects with iUVP and matched normal controls. Outcomes will eludicate
whether the size of vessel explains the predominance of left-sided iUVP. Systematic comparison of medical,
environmental, and genetic historical data between human subject groups will also enable identification of risk
factors associated with hypercompliance of the vasculature. Outcomes of this project will elucidate the role of
vascular hypercompliance on impaired RLN function in those with iUVP and determine co-morbidities ...

## Key facts

- **NIH application ID:** 10130482
- **Project number:** 5R01DC011311-09
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Julie M Barkmeier-Kraemer
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $479,050
- **Award type:** 5
- **Project period:** 2012-04-13 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10130482

## Citation

> US National Institutes of Health, RePORTER application 10130482, Vascular Connective Tissues as a Factor in onset of Idiopathic Vocal Fold Paralysis (5R01DC011311-09). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10130482. Licensed CC0.

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