The Effects of Chronic Electrical Stimulation on Laryngeal Muscle Physiology and Histochemistry

Zealear, David L.; Billante, Cheryl R.; Chongkolwatana, Cheerasook; Rho, Young Soo; Hamdan, Abdul‐Latif; Herzon, Garrett D.

doi:10.1159/000027722

Cited by 26 publications

(14 citation statements)

References 12 publications

(14 reference statements)

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“…In canine and ovine studies, functional electrical stimulation of the DCA muscle has produced vocal fold abduction and overcome airway obstruction (Broniatowski et al 1985;Kim et al 1987;Sanders 1991;Zrunek et al 1991). In addition, functional neuromuscular stimulation has been shown to increase muscle contractility in denervated canine DCA muscle (Zealear et al 2000). Stimulation also protected the muscle from atrophy by preventing muscle weight loss and type 2 fibre deterioration and rescued muscle fibres from undergoing fibrosis (Zealear et al 2000).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, functional neuromuscular stimulation has been shown to increase muscle contractility in denervated canine DCA muscle (Zealear et al 2000). Stimulation also protected the muscle from atrophy by preventing muscle weight loss and type 2 fibre deterioration and rescued muscle fibres from undergoing fibrosis (Zealear et al 2000). A neuroprosthesis offers the possibility of rapid restoration of function and this requires a more thorough neuroanatomical knowledge.…”

Section: Introductionmentioning

confidence: 99%

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Neuroanatomy of the equine dorsal cricoarytenoid muscle: Surgical implications

Cheetham

Radcliffe

Ducharme

et al. 2008

Equine Veterinary Journal

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neuroanatomy of the equine dorsal cricoarytenoid muscle: Surgical implications

Cheetham

Radcliffe

Ducharme

et al. 2008

Equine Veterinary Journal

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“…In 1977, Zealear and colleagues17,18 proposed that a signal from a normally innervated muscle could be used to control a stimulation signal that modulates the activity of a contralateral denervated muscle. Preliminary studies were performed in paralyzed dog laryngeal muscles stimulated by an open-loop device.…”

Section: Discussionmentioning

confidence: 99%

Toward an implantable functional electrical stimulation device to correct strabismus

Velez

Isobe

Zealear

et al. 2009

Journal of American Association for Pediatric Ophthalmology and

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PURPOSE-To investigate the feasibility of electrically stimulating the lateral rectus muscle to recover its physiologic abduction ability in cases of complete sixth cranial (abducens) nerve palsy.METHODS-In the feline lateral rectus muscle model, the effects of a charge-balanced, biphasic, current-controlled stimulus on the movement of the eye were investigated while stimulation frequency, amplitude, and pulse duration was varied. Eye deflection was measured with a force transducer. Denervated conditions were simulated by injection of botulinum toxin A.RESULTS-Three chemically denervated and 4 control lateral rectus muscles were analyzed. In control lateral rectus muscles, the minimum fusion frequency was approximately 170 Hz, and the maximum evoked abduction was 27°. The minimum fusion frequency was unchanged after 4 weeks of chemical denervation. Stimulation of chemically denervated lateral rectus muscle resulted in 17° of abduction. For both innervated and chemically denervated lateral rectus muscle, frequencies greater than 175 Hz yielded very little increase in abduction. Modulating amplitude produced noticeable movement throughout the tested range (0.2 to 9 mA). CONCLUSIONS-Results from the feline lateral rectus muscle showed that electrical stimulation is a feasible approach to evoke a contraction from a denervated lateral rectus muscle. The degree of denervation of the feline lateral rectus muscle was indeterminate. Varying the stimulation amplitude allowed greater eye movement. It is very likely that both frequency and amplitude must be modulated for finer control of static eye position.Congenital or acquired anomalous innervation and palsy of the extraocular muscles may result in severe amblyopia, loss of stereopsis, marked deficits in binocular visual fields, and diplopia. 1 The goal of strabismus treatment is to restore fusion and stereopsis and to enlarge A complete extraocular muscle palsy results in permanent denervation and muscle atrophy, which limits the outcome from surgical intervention on the affected muscle. Surgical correction is challenging and outcomes are limited, with many patients requiring several surgical procedures to reach alignment in the primary position.Several techniques have been described to remobilize a denervated striate muscle, including nerve-to-nerve anastomosis, neuromuscular pedicle transfer, and functional electrical stimulation (FES). [2][3][4][5][6][7][8][9][10][11] The use of FES has long been proposed as a potential treatment for restoring motor function of denervated motor systems. 2,4-11 Recent success has been noted in the ability of FES to allow paraplegics to gain the ability to stand. 5,6,9 FES may protect muscles from atrophy, promote muscle reinnervation from appropriate native motoneurons, and reconnect a muscle to the original endplate and its nerve fiber without interrupting the natural course of reinnervation and the potential for spontaneous recovery. [12][13][14][15][16][17][18] The validity of this approach has been demonstrated in humans.Z...

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“…The stimulus paradigm suitable for reanimation of the chronically denervated PCA muscle was identified. Chronic stimulation was found to restore abduction, increase PCA muscle contractility over the period of intervention, and protect the muscle from atrophy and fibrosis [21].…”

Section: Unilateral Laryngeal Pacingmentioning

confidence: 99%

Unilateral and Bilateral Laryngeal Pacing for Bilateral Vocal Fold Paralysis

Powell

Zealear

et al. 2020

Curr Otorhinolaryngol Rep

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Purpose of Review Present the state-of-the-art overview of laryngeal pacing for treatment of bilateral vocal fold paralysis. A minimally invasive unilateral pacing system and a fully implantable bilateral pacing system are currently in clinical trials. The relative advantages and disadvantages of each are discussed. Recent Findings Research in functional electrical stimulation for the reanimation of the posterior cricoarytenoid muscle has successfully translated from animal models to human clinical trials for unilateral pacing and bilateral pacing. Current findings suggest unilateral pacing in humans significantly improves ventilation but only marginally better than cordotomy. Bilateral pacing in canines increases glottal opening greater than 2-fold over unilateral pacing and restores exercise tolerance to normal. Summary Unilateral pacing can be considered a breathing assist device and may not be appropriate for active individuals. Bilateral pacing may be preferable for patients who wish to engage in strenuous exercise. Minimally invasive systems may be ideal for patients who prefer less invasive implantation and are not concerned with cosmesis. Fully implantable pacing systems offer greater electrode redundancy and stability, resulting in a system that is robust against electrode migration or damage.

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The Effects of Chronic Electrical Stimulation on Laryngeal Muscle Physiology and Histochemistry

Cited by 26 publications

References 12 publications

Neuroanatomy of the equine dorsal cricoarytenoid muscle: Surgical implications

Neuroanatomy of the equine dorsal cricoarytenoid muscle: Surgical implications

Toward an implantable functional electrical stimulation device to correct strabismus

Unilateral and Bilateral Laryngeal Pacing for Bilateral Vocal Fold Paralysis

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