The overall goal of this project is to establish a reliable means of reanimation of the paralyzed larynx in an animal model. The eventual direction of this research is to develop a device for human implantation to restore laryngeal function after vocal fold paralysis. The hypothesis driving this project is that an implanted electrode array in the peripheral recurrent laryngeal nerve (RLN) can selectively stimulate laryngeal adductor muscles and abductor muscles. This principle can then be used to design a device that will reanimate a paralyzed vocal fold and restore laryngeal functions of phonation and respiration. Thus, the major outcome variable is to restore physiologic adductor and abductor vocal fold movement. In work toward these goals, a well-established cat model of laryngeal paralysis is used to explore the potential applications of this device.
The specific aims of this proposal include: 1) Determine the topographic orientation of the nerve fibers in the RLN in the region where an electrode array can be implanted, 2) Determine the feasibility of selective reanimation of vocal fold movement in an animal vocal fold paralysis model by electrode array stimulation of the RLN in two surgical conditions of RLN-RLN neurorraphy, and ansa-RLN neurorraphy, and 3) Determine the long-term stability of electrode array implant in the RLN. To accomplish these aims, the surgical procedures will be performed in the animal model and electrode array implanted after the neurorraphy has healed. The electrode array is selectively stimulated, laryngoscopy and laryngeal EMG is performed to observe for vocal fold adductor and abductor movement and activation. The electrode array is secured and wired to an external pedestal mounted on the head. This allows serial electrode stimulation and observations of laryngeal movement over an extended length of time. Nerve samples will be harvested and studied to examine the effects of the implanted array on RLN fibers. ? ?
| Smith, Marshall E; Roy, Nelson; Stoddard, Kelly (2008) Ansa-RLN reinnervation for unilateral vocal fold paralysis in adolescents and young adults. Int J Pediatr Otorhinolaryngol 72:1311-6 |
