Development of Electromagnetic Stimulation System to Aid Patients Suffering From Vocal Fold Paralysis

2013 ◽  
Author(s):  
William Garret Burks ◽  
Paola Jaramillo ◽  
Alexander Leonessa
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Laryngeal Nerve ◽  
Surgical Trauma ◽  
Frequency Change ◽  
Airway Protection ◽  
Laryngeal Muscles ◽  
Electromagnetic Stimulation ◽  
Stimulation System

Vocal fold paralysis affects approximately 7.5 million Americans. Paralysis can be caused by numerous conditions, including head, neck or surgical trauma, endotracheal intubation, neurological conditions, cancer, tumors, just to mention a few. Currently, vocal fold paralysis treatment involves surgery and voice therapy. The vocal folds are composed of a three part material stretched along the larynx, which enables frequency change. Intrinsic laryngeal muscles coordinate the motion of vocal folds during respiration, vocalization, and aid in airway protection. Sensory information is carried by the Superior Laryngeal Nerve (SLN) and the Recurrent Laryngeal Nerve (RLN). Injury to the RLN results in paralysis of all laryngeal muscles excluding the cricothyroid muscle [1]. Although optimal larynx reinnervation has been extensively researched and implemented to improve voice paralysis [2], voice electrotherapy offers an alternative to effectively stimulate the larynx muscles for voice production, breathing and airway protection. One of the main causes of voice disorders is neurological in nature and causes abnormal vocal fold vibration. Of particular importance to this research is paralysis due to RLN injury, which causes acute temporary paralysis [3]. Currently, invasive electrical stimulus is used to activate muscle function; however, abnormal activation of muscle patterns causes muscles to function out of synchronization resulting in low vocal output [4]. For this reason, our work focuses on the development of an effective electromagnetic stimulation system to aid patients with unilateral vocal fold paralysis by stimulating the RLN and in turn reinnervating the adequate laryngeal muscles involved in the vocal fold motion for the purposes of sound vocalization, respiration, and airway protection. So far, a proof of principle has been developed and evaluated to assess the system’s feasibility. The preliminary experiments have been conducted using BioMetal Fibers (BMF) (Toki Corporation, Japan), which are fiber-like solid state actuators designed to contract and extend similar to muscles. BMF contracts when stimulated through a current generated in this case through an electromagnetic field.

Indirect Microsurgery of the Vocal Folds - Videostroboscopy vs. Microstroboscopy

1993 ◽  
Vol 72 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Zoran Milutinović
Keyword(s):  
Laser Surgery ◽  
Vocal Fold ◽  
Vocal Folds ◽  
Surgical Approaches ◽  
Surgical Trauma ◽  
Benign Lesions ◽  
Functional Control ◽  
Microlaryngeal Surgery ◽  
Surgical Manipulation ◽  
Vocal Fold Surgery

In spite of the great significance of direct microlaryngeal surgery (DML), the inadequacies of this technique are evident. In order to avoid surgical trauma and introduce functional control during surgery, indirect microstroboscopic (IMS) and indirect videostroboscopic surgery (IVS) of the vocal folds are advocated. Both of these meet most criteria for surgical work in this field. The aim of this work was to make a comparative study of these techniques. The study is based on 603 operations conducted for benign lesions of the vocal folds. We are of the opinion that indirect vocal fold surgery for small benign lesions has significant advantages when compared with the conventional microlaryngoscopy, including laser surgery, which was proven elsewhere. When comparing these two indirect surgical approaches, the principal advantages of IVS surgery over the IMS method are easier surgical manipulation and better view. With respect to other areas of comparison, these techniques are quite similar. As complementary methods to conventional microlaryngoscopy, we believe that both IVS and IMS surgery should be used in practice.

Vocal Evaluation of Thyroplasty Type I in the Treatment of Nonparalytic Glottic Incompetence

1998 ◽  
Vol 107 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Fang-Ling Lu ◽  
Donna S. Lundy ◽  
Roy R. Casiano ◽  
Jun-Wu Xue
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Perceptual Judgment ◽  
Function Evaluation ◽  
Type I ◽  
Unilateral Vocal Fold Paralysis ◽  
Vocal Function ◽  
Voice Outcome ◽  
Minimal Improvement

This study investigated the prethyroplasty and postthyroplasty voices of patients with glottic incompetence of mobile vocal folds related to vocal fold bowing and scarring. Seventeen patients underwent vocal function evaluation preoperatively and 1 month postoperatively with videostrobolaryngoscopic examination, acoustic and aerodynamic analysis, and perceptual judgment of voice characteristics. The postoperative voice outcome in this group of patients was compared to that of a group of patients with unilateral vocal fold paralysis. Patients with vocal fold bowing showed significant improvement in glottic gap size and hoarseness after the surgery. There was minimal improvement on other test measures. Patients with vocal fold scarring exhibited worse preoperative and postoperative vocal functions, with little voice improvement after surgery. The outcome of thyroplasty type I in cases of vocal fold bowing or scarring is not as good as that in unilateral vocal fold paralysis.

The role of stroboscopy in the management of a patient with a unilateral vocal fold paralysis

1996 ◽  
Vol 110 (2) ◽  
pp. 141-143 ◽  
Author(s):  
Meredydd Lloyd Harries ◽  
Murray Morrison
Keyword(s):  
Surgical Treatment ◽  
Diagnostic Tool ◽  
Vocal Fold ◽  
Speech Therapy ◽  
Muscle Tone ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis

AbstractStroboscopy is well established as an essential diagnostic tool in the assessment of the vocal folds during phonation. This paper analyses the stroboscopic findings in 100 patients with a unilateral vocal fold paralysis. Reliable stroboscopic signals were only obtained in patients with the paralysed fold close to the midline. These patients seldom require surgery however, usually responding to speech therapy with laryngeal compensation giving a good voice. Most patients that require surgery have a large glottal deficiency, but in this series these patients did not give an adequate signal for analysis. Although useful in the assessment of the muscle tone of the paralysed fold, the influence of stroboscopy on the surgical treatment in this series was limited.

Spontaneous regeneration of recurrent laryngeal nerve following long-term vocal fold paralysis in humans: Histologic evidence

2011 ◽  
Vol 121 (5) ◽  
pp. 1035-1039 ◽  
Author(s):  
Donghui Chen ◽  
Shicai Chen ◽  
Wei Wang ◽  
Chuansen Zhang ◽  
Hongliang Zheng
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Laryngeal Nerve ◽  
Histologic Evidence ◽  
Spontaneous Regeneration

Autologous Fat Injection for Vocal Fold Paralysis: Long-Term Histologic Evaluation

1995 ◽  
Vol 104 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Lauren S. Zaretsky ◽  
Michael deTar ◽  
Maisie L. Shindo ◽  
Dale H. Rice
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Laryngeal Nerve ◽  
Fat Injection ◽  
Autologous Fat ◽  
Alloplastic Materials ◽  
Histologic Evaluation ◽  
Left Recurrent Laryngeal Nerve ◽  
Thyroarytenoid Muscle

Many techniques have been developed for medialization of the paralyzed vocal fold. The purpose of this study is to evaluate autologous fat as an alternative to alloplastic substances for use in vocal fold medialization. Eight dogs underwent left recurrent laryngeal nerve sectioning. Autologous fat was harvested, and the paralyzed vocal fold was medialized by injecting the fat into the thyroarytenoid muscle. The animals were divided into three groups for evaluation at 1, 3, and 6 months. Videolaryngoscopy was performed prior to sacrificing the animals. The larynges were sectioned coronally, and histologic studies were performed. The studies confirmed the preservation of viable fat at the injected site in all animals. Only a minimal inflammatory response was observed in the 1-month group. It would appear that fat injection is a viable alternative to Teflon injection and thyroplasty; it eliminates the need for alloplastic materials, does not appear to migrate, and does not require an open procedure.

Long-term histological outcomes of injected autologous fat into human vocal folds after secondary laryngectomy

2005 ◽  
Vol 132 (5) ◽  
pp. 685-688 ◽  
Author(s):  
Hisanori Sasai ◽  
Yusuke Watanabe ◽  
Hiroshi Muta ◽  
Junichi Yoshida ◽  
Ibuki Hayashi ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Histological Evaluation ◽  
Fat Injection ◽  
Special Equipment ◽  
Autologous Fat ◽  
Vocal Fold Augmentation ◽  
Disposable Needle

OBJECTIVE: To histologically evaluate the long-term outcomes of autologous fat grafts after injection laryngoplasty in the human larynx. STUDY DESIGN AND SETTING: We injected liposuctioned fat for vocal fold augmentation in patients with vocal fold paralysis. We suctioned autologous fat from the low abdomen with an 18-G disposable needle and a 20-mL disposable syringe under negative pressure. This is different from the conventional liposuction technique and avoids the use of special equipment. In this article, we report the histological evaluation of 2 patients (patient 1: 12 months, patient 2: 41 months) who required total laryngectomy after autologous fat injection into the vocal folds. RESULTS: Histological examination revealed normal-appearing viable adipocytes with minimal inflammatory response in both patients. CONCLUSIONS: Our liposuctioned autologous fat injection histologically offered long-term improvement in patients with impaired glottal closure from vocal fold paralysis. (Otolaryngol Head Neck Surg 2005;132:685-688.)

Cervical osteophytes presenting as unilateral vocal fold paralysis and dysphagia

2001 ◽  
Vol 115 (5) ◽  
pp. 422-424 ◽  
Author(s):  
Adi Yoskovitch ◽  
Stephen Kantor
Keyword(s):  
Vocal Fold ◽  
Superior Laryngeal Nerve ◽  
Vocal Fold Paralysis ◽  
Laryngeal Nerve ◽  
Unilateral Vocal Fold Paralysis ◽  
Unique Case ◽  
Common Cause ◽  
Extrinsic Compression ◽  
External Branch ◽  
Cervical Osteophytes

Any process involving either the vagus nerve, its recurrent laryngeal branch or the external branch of the superior laryngeal nerve may cause paralysis of the vocal fold. The most common cause is neoplasm. Clinically, the patients often present with a hoarse, breathy voice as well as symptoms of aspiration. The following represents a unique case of unilateral vocal fold paralysis and dysphagia caused by a degenerative disease of the cervical spine, resluting in extrinsic compression of the recurrent laryngeal nerve.

Sign in / Sign up

Export Citation Format

Share Document