Document Detail

Reanimation of the paralyzed human larynx with an implantable electrical stimulation device.
MedLine Citation:
PMID:  12838013     Owner:  NLM     Status:  MEDLINE    
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.
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
Related Documents :
8432153 - Rate of decay or increment of pao2 following a change in supplemental oxygen in mechani...
943273 - Estimation of the resting reflex hypoxic drive to respiration in patients with diffuse ...
2090613 - Expectations and psychological needs of elderly dialysis patients.
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Laryngoscope     Volume:  113     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-02     Completed Date:  2003-08-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1149-56     Citation Subset:  IM    
Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical School, Medical Center North S2100, Nashville, TN 37232, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Electric Stimulation Therapy* / instrumentation
Inspiratory Capacity
Laryngeal Muscles / innervation,  physiopathology
Middle Aged
Mouth Breathing
Prospective Studies
Prostheses and Implants
Vocal Cord Paralysis / physiopathology,  therapy*
Vocal Cords / physiopathology
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Age-related mechanisms of cricoid cartilage response to injury in the developing rabbit.
Next Document:  Pitch-raising surgery in fourteen male-to-female transsexuals.