Neurostimulation with Laryngeal Pacemaker Does Not Affect Vocal Quality

Although transoral laser surgical glottic enlargement is considered the gold-standard treatment for BVFP (bilateral vocal fold paralysis), respiratory function improvement often correlates with voice quality deterioration due to the irreversible and static modification of the vocal fold conformation. Selective neurostimulation could be a promising BVFP therapy based on the dynamic restoration of vocal fold mobility.
At the post-implantation visit, videolaryngoscopy descriptive evaluation showed that the targeted vocal fold responded to the neurostimulation by shifting from a paramedian to a lateral position (abduction), resulting in a dynamic and transient enlargement of the glottal gap nearly mimicking the physiological situation of a healthy vocal fold during respiration. During phonation, the physiological adduction overrode the stimulated abduction, and both vocal folds were driven back in a median position. Weekly self-assessment with a PEF meter showed significant improvement a week after LP system activation.
Limitations included a limited sample size, and previous contralateral glottic enlargement in four of seven participants.
Hamaker AE ENTtoday, August 15, 2017
Citation: Mueller AH, Hagen R, Pototschnig C. Laryngeal pacing for bilateral vocal fold paralysis: voice and respiratory aspects. Laryngoscope. 2017;127:1838–1844.
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