| Reanimation of the paralyzed human larynx with an implantable electrical stimulation device. | |
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MedLine Citation:
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PMID: 12838013 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES/HYPOTHESIS: Electrical stimulation of the posterior cricoarytenoid muscle, when paced with inspiration, offers a physiological approach to restore ventilation in bilateral laryngeal paralysis without any of the disadvantages associated with conventional treatment. STUDY DESIGN: A prospective study of six patients. METHODS: The patients were successfully implanted with an Itrel II stimulator (Medtronic, Inc). In postoperative sessions, stimulated vocal fold abduction, patient ventilation, and voice were assessed and compared with preoperative values. RESULTS: The optimum stimulus paradigm was a 1- to 2-second train of 1-millisecond pulses delivered at a frequency of 30 to 40 Hz and amplitude of 2 to 7 V. Posterior cricoarytenoid stimulation produced a large dynamic abduction (3.5-7 mm) in three patients and moderate abduction (3 mm) in a fourth patient. The fifth patient showed a large but delayed response of 4 mm to stimulation with some lateralization of the vocal fold. In the sixth patient, stimulated abduction was noted on device implantation but was lost postoperatively. All five patients with stimulated abduction postoperatively met the ventilatory criteria for decannulation, and three patients subsequently had decannulation. Long-term stimulation of the posterior cricoarytenoid muscle had no appreciable effect on voice quality. CONCLUSIONS: Electrical stimulation of the posterior cricoarytenoid muscle shows potential as an improved therapy for bilateral vocal fold paralysis. |
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Authors:
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David L Zealear; Cheryl R Billante; Mark S Courey; James L Netterville; Randal C Paniello; Ira Sanders; Garrett D Herzon; George S Goding; Wolf Mann; Hasse Ejnell; Alfons M M C Habets; Roy Testerman; Paul Van de Heyning |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The Laryngoscope Volume: 113 ISSN: 0023-852X ISO Abbreviation: Laryngoscope Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-07-02 Completed Date: 2003-08-07 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: United States |
Other Details:
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Languages: eng Pagination: 1149-56 Citation Subset: IM |
Affiliation:
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Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical School, Medical Center North S2100, Nashville, TN 37232, USA. david.zealear@vanderbilt.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Electric Stimulation Therapy* / instrumentation Electromyography Female Humans Inspiratory Capacity Laryngeal Muscles / innervation, physiopathology Male Middle Aged Mouth Breathing Prospective Studies Prostheses and Implants Vocal Cord Paralysis / physiopathology, therapy* Vocal Cords / physiopathology |
| Grant Support | |
ID/Acronym/Agency:
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2R01 DC 01149/DC/NIDCD NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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