Evaluation of a deep brain stimulation electrode for laryngeal pacing.
OBJECTIVE
The purpose of the present study was to evaluate the suitability of a deep brain stimulation electrode for laryngeal pacing. Of interest was whether the smaller and more closely spaced channels could provide sufficient channel redundancy, controlled current distribution, and discrete activation of the posterior cricoarytenoid (PCA) muscle.


METHODS
A study was conducted in dogs under differing states of PCA muscle innervation representing complete denervation to complete synkinetic reinnervation. In 3 animals, stimulated glottal opening was assessed in the innervated state and after chemical denervation by pancuronium bromide. In 3 additional dogs, the left side of the larynx was surgically denervated and compared to the innervated, right side to study an anatomic model of clinical paralysis.


RESULTS
The thresholds were lower and the maximum level of abduction was greater for the innervated state. The stimulated glottal opening equaled that of a spontaneously breathing animal. Abductory responses were obtained across all channels in the array, demonstrating its anatomic and physiological compatibility for this application. In the denervated state, responses were only 20% of that of the innervated state with a pulse duration of 0.5 ms. The response could be enhanced to 40% and 60% by increasing the pulse duration to 1 and 2 ms.


CONCLUSIONS
A deep brain stimulation electrode could effectively reanimate the PCA muscle to a normal level in a case of synkinetic reinnervation and to as much as 60% of the normal level in a case of complete denervation.
Katada
Akihiro
A
Department of Otolaryngology, Medical Center North S2100, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Van Himbergen
Daniel
D
Kunibe
Isamu
I
Nonaka
Satoshi
S
Harabuchi
Yasuaki
Y
Huang
Shan
S
Billante
Cheryl R
CR
Zealear
David L
DL
D000818:Animals; D001193:Arytenoid Cartilage; D003413:Cricoid Cartilage; D046690:Deep Brain Stimulation / Q000295:instrumentation*; D004285:Dogs; D004867:Equipment Design; D007821:Laryngeal Muscles / Q000294:innervation*; D009121:Muscle Denervation / Q000379:methods; D009416:Nerve Regeneration / Q000502:physiology*; D014826:Vocal Cord Paralysis / Q000628:therapy*