Адренергическая и холинергическая иннервация опухолеподобных образований голосовых складок у больных c вегетативными расстройствами

Abstract

To develop therapeutic measures aimed at improving the voice and including exposure to specific mechanisms of the autonomic nervous system (ANS), it is necessary to know the features of the autonomic innervation of the vocal folds, which has a significant impact on the work of the vocal apparatus by regulating the trophic state of the elements forming it. Objective. Histochemical detection of adrenergic and cholinergic nerve fibers in tumor-like formations of vocal folds in patients with autonomic disorders. Materials and methods. A comprehensive examination of 64 patients with impaired voice function was carried out. During the examination, the medical history was studied, an objective examination of the upper respiratory tract according to generally accepted methods and with the help of video stroboscopic instrumentation, a cytological examination of touch preparation from the affected laryngeal area, and a study of the functional state of the ANS from the surgical material, including histological and histochemical examination of the removed tissue, were carried out. As a result, all patients were clinically diagnosed with a vocal fold polyp. Results. Histological, histochemical, and cytological studies have shown that in 80% of patients morphofunctional alterations of the vocal folds were combined with inadequate autonomic maintenance of activity. The data obtained allow us to assume that hyperplastic compensatory and adaptive responses of the laryngeal mucosa pass to pathological dystrophic changes and may contribute to deviations of the mucosal epithelium from normal histological differentiation toward atypia. Such changes create conditions for the development of benign and malignant tumors. Conclusion. In general, the data obtained give reason to believe that with prolonged dysfunction of the ANS a neurodystrophic process develops in the body, taking part in the pathogenesis of various diseases, including diseases of the larynx. With this in mind when performing preventive and therapeutic measures aimed at patients with tumor-like formations of the vocal folds, it is necessary to assess the functional state of the ANS and include measures to correct autonomic parameters in the general treatment and rehabilitation regimen.