# The Effect of Preterm Birth and RLN Damage on Airway Protection and Maturation

> **NIH NIH R01** · NORTHEAST OHIO MEDICAL UNIVERSITY · 2020 · $472,317

## Abstract

Coordination among the functional components of the aerodigestive system, particularly
between swallowing and respiration, is critical for successful airway protection in infants.
Disruption of this coordination can produce failure of airway protection, manifest as pulmonary
aspiration. Preterm birth is one cause of this disruption and subsequent aspiration. These
problems may be compounded with damage to the recurrent laryngeal nerve (RLN) resulting
from cardiovascular repairs necessitated by prematurity. Because the current understanding of
the pathologies in these fragile patients is based largely on non-invasive technologies, the
causal relationship between disordered coordination and airway protection, including how
development impacts this system, is unknown. In particular, we do not know the biomechanical
alterations that cause aspiration nor what, if any, longitudinal changes occur in biomechanics
that may promote airway protection. We propose to investigate the longitudinal course of
maturation of airway protection in preterm/term infants, with and without RLN damage. The use
of a validated preterm animal model will permit the collection of detailed data, using invasive
methods, including high-speed, biplanar videofluoroscopy, that are not appropriate for human
patients. The work proposed here will determine how preterm birth effects the sensorimotor
interactions that underlie successful airway protection as well as how RLN damage impacts
those interactions through three specific aims: (SA1) Determine the longitudinal development of
coordination between respiration and swallowing in control infant pigs born at term from birth
through weaning; (SA2) Determine the longitudinal development of the coordination between
respiration and swallowing after preterm birth using pigs delivered at the equivalent of human
gestational age of 30-32 weeks; (SA3) Determine the interaction between the maturation of
airway protection and RLN injury in both (SA3a) control term infants and (SA3b) preterm infants.
By working with a proven and validated animal model of translational importance, the study
proposed here will provide data on the underlying normal and pathophysiologic mechanisms
that cause failure of airway protection in preterm infants. These data, collected longitudinally
and in sufficient quantity to assess within individual variation and ontogenetic changes within
individuals, will provide insight not possible from human patients. Such data will change our
understanding of the potential for recovery and treatment recommendations. Furthermore these
data can be the basis for designing intervention strategies based on understanding of the
mechanisms underlying the pathophysiology.

## Key facts

- **NIH application ID:** 9906065
- **Project number:** 5R01HD088561-05
- **Recipient organization:** NORTHEAST OHIO MEDICAL UNIVERSITY
- **Principal Investigator:** Rebecca Z German
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $472,317
- **Award type:** 5
- **Project period:** 2016-08-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9906065

## Citation

> US National Institutes of Health, RePORTER application 9906065, The Effect of Preterm Birth and RLN Damage on Airway Protection and Maturation (5R01HD088561-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9906065. Licensed CC0.

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