Presented at the 2012 American Laryngological Association Meeting, San Diego, California, U.S.A., April 19, 2012.
Article first published online: 9 AUG 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 9, pages 2015–2022, September 2012
How to Cite
Broniatowski, M., Grundfest-Broniatowski, S., Hahn, E. C., Hadley, A. J., Tyler, D. J. and Tucker, H. M. (2012), Selective intraoperative stimulation of the human larynx. The Laryngoscope, 122: 2015–2022. doi: 10.1002/lary.23464
This work was funded by St. Vincent Charity Medical Center and Department of Biomedical Engineering, Case Western Reserve University. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 23 AUG 2012
- Article first published online: 9 AUG 2012
- Manuscript Accepted: 3 MAY 2012
- Manuscript Revised: 1 APR 2012
- Manuscript Received: 29 FEB 2012
- Human laryngeal manipulation;
- functional electric stimulation;
- electromyography of intrinsic laryngeal muscles
Laryngeal contraction normally entails activation of mutually cooperative intrinsic laryngeal muscles (ILMs). Unfortunately, standard stimulating methods do not completely mimic the normal ongoing synchrony between the muscles. We submit that this problem can be addressed by modifying the stimulating waveform.
This study extends prior canine research to the human using quasitrapezoidal (QT) currents instead of standard square waves, which while valuable incompletely express normal ILM interactions.
In two patients undergoing laryngectomy for cancer, the recurrent laryngeal nerve on the uninvolved side received QT pulses (4 Hz, 60–2,000 μA, 100–500 μs width, 0–500-μs decay) via a bipolar cuff electrode. Pairs of needle electrodes placed into the posterior cricoarytenoideus (PCA), lateral cricoarytenoideus (LCA), and thyroarytenoideus (TA) were used to record electromyography amplitudes, and waveforms were analyzed by a specially designed computer program.
With activity from square waves serving as control, we observed statistically significant (P < .05) shifts in mutual relationships among PCA, LCA, and TA for an array of specific QT configurations.
Our preliminary data on selective ILM manipulation offer promise for improved dynamic control of faulty laryngeal contraction patterns.