Comparison between Intramuscular Multichannel Electrodes and Supramysial Multichannel Electrodes via EMG Measurements for Potential Use as Larynx Stimulation Electrodes: In Vivo Animal Analysis

Abstract

One of the most common causes for larynx paralysis is the injury of the recurrent laryngeal nerve which, among others, causes the paralysis of the posterior cricoarytenoideus muscle (PCA). Electrical stimulation of PCA offers an approach to retaining the function of the paralyzed larynx muscle. The study aim was to test the applicability of an intramuscular multichannel array electrode as a measuring electrode for myoelectrical potentials and as a possible electrode for stimulation, e.g., posterior cricoarytenoideus muscle stimulation. For this purpose, two different kinds of electrodes were compared. 42 intramuscular multichannel array electrodes and 11 supramysial multichannel electrodes were implanted into the triceps brachii muscle of rats. The triceps brachii muscle of rats is suitable to serve as a substitute muscle for the human PCA muscle in an in vivo animal model. It has the same striated muscle cells, is of comparable size, and fundamentally serves a similar function to the human PCA muscle during normal respiration. Walking and breathing are circular functions that cause minimal muscle fatigue when carried out steadily. In total, the myoelectrical activity of 6703 steps could be recorded, allowing a comparison and statistical analysis of the EMG amplitudes and EMG activation patterns. Small differences can be detected between the EMG signals of both electrode types which, however, can be explained physiologically. Both electrode types reveal the basic characteristics of the triceps brachii muscle activity, namely the muscle contraction strength and the coordination pattern. This indicates that the intramuscular electrode may be applied for a detailed analysis of the human larynx.

An Endoscopic Cap Electrode for Posterior Cricoarythenoid Muscle Stimulation in a Porcine Model

“…Neurolaryngology is a young and rapidly evolving subdiscipline in laryngology, which strives towards novel diagnostic and therapeutic options in alignment with general progress in sensor engineering, implantation technology and re-innervation surgery techniques. [1][2][3][4][5] Neuromuscular electrical stimulation (NMES) of the posterior cricoarytenoid muscle (PCA) is a proposed therapeutic concept to treat patients suffering from bilateral vocal fold paresis (BVFP) with synkinesis to restore vocal fold movement. 6 Beginning with proof-of-concept studies in various animal models it has evolved over the past decades to implantable medical devices for first in human trials.…”