Phonation Analysis Combined with 3D Reconstruction of the Thyroarytenoid Muscle in Aged Ovine Ex Vivo Larynx Models

Gerstenberger, Claus; Döllinger, Michael; Kniesburges, Stefan; Bubalo, Vladimir; Karbiener, Michael; Schlager, Hansjörg; Sadeghi, Hossein; Wendler, Olaf; Gugatschka, Markus

doi:10.1016/j.jvoice.2017.08.016

Cited by 12 publications

(37 citation statements)

References 34 publications

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“…The increase of the TAM diameter (midmembranous part) was even higher and close to 40%. We know from an unstimulated control group of similar aged sheep, that the TAM volumes (right vs. left) do not differ …”

Section: Discussionmentioning

confidence: 90%

“…For estimating the results of FES, we compared the stimulated VF versus the unstimulated VF in one and the same animal. Previous studies in an age‐matched cohort showed that in the unstimulated animal right and left VF did not differ in its dimensions …”

Section: Methodsmentioning

confidence: 89%

“…All procedures were carried out as described in a previous study . Briefly, the harvested larynges were placed in 3.75% iodine potassium iodide solution as a contrast agent before being scanned.…”

Section: Methodsmentioning

confidence: 99%

“…For sample size estimation, the effect size was chosen based on the rationale that a 30% increase in TAM diameter D (measured in the horizontal plane perpendicular to the course of the TAM) would be desirable from a clinical perspective. α and β values were chosen as 0.05 and 0.1, respectively, whereas the standard deviation of D was calculated from a previous cohort of aged sheep (mean = 2.54 mm ± 0.43 mm) . These parameters resulted in a minimum sample size of n = 6 (power = 92%, effect size: 1.74).…”

Section: Methodsmentioning

confidence: 99%

“…All procedures were carried out as described in a previous study. 9 Briefly, the harvested larynges were placed in 3.75% iodine potassium iodide solution as a contrast agent before being scanned. The images were segmented, 3D reconstructed, and the volume determination of the TAM was performed with the 3D visualization and analysis software Avizo 9.3 (Field Electron and Ion Co., Hillsboro, OR).…”

Section: Micro Computed Tomography Scans and Reconstructionmentioning

confidence: 99%

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Functional Electrical Stimulation Leads to Increased Volume of the Aged Thyroarytenoid Muscle

et al. 2018

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Objectives/Hypothesis To reverse sarcopenia and increase the volumes of atrophied laryngeal muscles by functional electrical stimulation (FES) using a minimal invasive surgical procedure in an aged ovine model. Study Design Prospective animal study. Methods A stimulation electrode was placed unilaterally near the terminal adduction branch of the recurrent laryngeal nerve (RLN) adjacent to the right cricothyroid joint. The electrode was connected to an implant located subcutaneously at the neck region. Predesigned training patterns were automatically delivered by a bidirectional radio frequency link using a programming device and were repeated automatically by the implant every other day over 11 weeks in the awake animal. Outcome parameters comprised volumetric measurements based on three‐dimensional reconstructions of the entire thyroarytenoid muscle (TAM), as well as gene expression analyses. Results We found significant increases of the volumes of the stimulated TAM of 11% and the TAM diameter at the midmembranous parts of the vocal folds of nearly 40%. Based on gene expression, we did not detect a shift of muscle fiber composition. Conclusions FES of the terminal branches of the RLN is a secure and effective way to reverse the effects of age‐related TAM atrophy and to increase volumes of atrophied muscles. Level of Evidence NA Laryngoscope , 128:2852–2857, 2018

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Section: Discussionmentioning

confidence: 90%

Section: Methodsmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Micro Computed Tomography Scans and Reconstructionmentioning

confidence: 99%

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Functional Electrical Stimulation Leads to Increased Volume of the Aged Thyroarytenoid Muscle

et al. 2018

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Functional Electrical Stimulation for Presbyphonia: A Prospective Randomized Trial

Gugatschka

Feiner

Mayr³

et al. 2020

The Laryngoscope

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The aim of this prospective study was to examine the effects of transcutaneous functional electrical stimulation (FES) in a group of elderly women with presbyphonia. Study Design: Prospective randomized study. Methods: Fourteen participants were enrolled prospectively and attributed randomly to two different treatment groups, where one group (n = 7) received 8 weeks of training (5 days a week), whereas the other group (n = 7) received 4 weeks of ineffective stimulation, followed by 4 weeks of effective training. Stimulation protocols were established during baseline examination and confirmed with endoscopy to ensure a glottal reaction. Numerous acoustical, vocal, patient-centered, and respiratory parameters were obtained at several time points. Results: Neither 4 weeks nor 8 weeks of functional electrical transcutaneous stimulation led to changes of vocal, acoustical, or respiratory parameters, apart from patient-centered items (Voice Handicap Index 12, Voice-Related Quality of Life), which improved over time. However, there were no differences between the two arms for both items. Conclusions: Transcutaneous FES over 4 weeks and 8 weeks did not lead to significantly improved objective voice and acoustical parameters, which could be caused by the fact that the muscles of interest cannot be targeted specifically enough. However, we found a significant improvement of subjective voice perception and voice-related quality of life in both groups. We explain this finding with an observer-expectancy effect secondary to the very time-consuming and elaborate study procedures.

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Bilateral Functional Electrical Stimulation for the Treatment of Presbyphonia in a Sheep Model

Kirsch,

Gerstenberger,

Jakubaß

et al. 2023

The Laryngoscope

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ObjectivesThe aim of the study was to increase muscle volume and improve phonation characteristics of the aged ovine larynx by functional electrical stimulation (FES) using a minimally invasive surgical procedure.MethodsStimulation electrodes were placed bilaterally near the terminal adduction branch of the recurrent laryngeal nerves (RLN). The electrodes were connected to battery powered pulse generators implanted subcutaneously at the neck region. Training patterns were programmed by an external programmer using a bidirectional radio frequency link. Training sessions were repeated automatically by the implant every other day for 1 week followed by every day for 8 weeks in the awake animal. Another group of animals were used as sham, with electrodes positioned but not connected to an implant. Outcome parameters included gene expression analysis, histological assessment of muscle fiber size, functional analysis, and volumetric measurements based on three‐dimensional reconstructions of the entire thyroarytenoid muscle (TAM).ResultsIncrease in minimal muscle fiber diameter and an improvement in vocal efficiency were observed following FES, compared with sham animals.ConclusionThis is the first study to demonstrate beneficial effects in the TAM of FES at molecular, histological, and functional levels. FES of the terminal branches of the RLN reversed the effects of age‐related changes and improved vocal efficiency.Level of EvidenceNA Laryngoscope, 2023

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Phonation Analysis Combined with 3D Reconstruction of the Thyroarytenoid Muscle in Aged Ovine Ex Vivo Larynx Models

Cited by 12 publications

References 34 publications

Functional Electrical Stimulation Leads to Increased Volume of the Aged Thyroarytenoid Muscle

Functional Electrical Stimulation Leads to Increased Volume of the Aged Thyroarytenoid Muscle

Functional Electrical Stimulation for Presbyphonia: A Prospective Randomized Trial

Bilateral Functional Electrical Stimulation for the Treatment of Presbyphonia in a Sheep Model

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