Treatment of Vocal Fold Bowing Using Neuromuscular Electrical Stimulation

Abstract

Behavioral voice therapy with adjunctive neuromuscular electrical stimulation reduced vocal fold bowing, resulting in improved acoustic, laryngeal, and patient-centered outcomes. Maximum phonation time and glottal closure results imply increased vocal fold tension secondary to enhanced thyroarytenoid or cricothyroid muscle function after voice therapy.

The effects of surface electrical stimulation plus voice therapy in Parkinson's disease

“…Their study designs with regard to the applied type of electrical stimulator, stimulation paradigm and voice assessment protocol were also not comparable. 13,34,40,41 A central cueing effect of the motor-or sensory level stimulus helping the patient to improve the vocal function was expected but was ultimately not found in the present idiopathic Parkinson's disease sample. 17,42 In idiopathic Parkinson's disease, a deficit in the basal ganglia can result in disturbed internal cueing of automatic, sequential movements, such as gait, voice or swallowing.…”

“…12 Furthermore, seven patients with bilateral vocal fold bowing were enrolled in a study by Lagorio et al . 13 Voice therapy with adjunctive surface electrical stimulation seemed to reduce vocal fold bowing resulting in improved acoustic, laryngeal and patient-reported outcome measures in this study. 13…”

“…13 Voice therapy with adjunctive surface electrical stimulation seemed to reduce vocal fold bowing resulting in improved acoustic, laryngeal and patient-reported outcome measures in this study. 13…”

“…33 On the grounds of clinical experience and the literature, we assumed that adding a peripheral stimulus at a sufficient intensity over the suprahyoid triangle with suprahyoid muscles and innervations from cervical and cranial nerves such as the trigeminal, hypoglossal with ansa cervicalis and superior laryngeal nerves (internal and external branches) originating from the vagal nerve could alter the videolaryngostroboscopic characteristics and the idiopathic Parkinson's disease patients' self-assessment of voice. 13,23,34 A significantly positive therapeutic effect within group 2 for the Voice Handicap Index-Emotional, Voice Handicap Index-Functional and Voice Handicap Index-Total (sub)scales was found. However, when comparing this therapeutic effect of group 2 with the Voice Handicap Index outcomes of group 1 and 3, the motor level surface electrical stimulation did not have a significant additional therapeutic effect.…”

Functional Electrical Stimulation for Presbyphonia: A Prospective Randomized Trial

“…Data on FES and presbylarynges are scarce, and to date there is only one prospective study (n = 6) where VF bowing was treated with behavioral therapy in combination with FES (five secondary to presbylarynges, one postintubational). 35 Behavioral therapy with adjunctive FES improved the VHI (five out of six, not significant) and MPT (only significant for /i/); loudness data were not reported. In addition, a control group was not included.…”