Broniatowski Michael, Grundfest-Broniatowski Sharon, Tucker Harvey M, Tyler Dustin J
Department of Surgery (Otolaryngology-Head and Neck Surgery), Saint Vincent Charity Hospital, University Hospitals Health System, USA.
Ann Otol Rhinol Laryngol. 2007 Feb;116(2):145-55. doi: 10.1177/000348940711600211.
We hypothesized that voice may be artificially manipulated to ameliorate dystonias considered to be a failure in dynamic integration between competing neuromuscular systems.
Orderly intrinsic laryngeal muscle recruitment by anodal block via the recurrent laryngeal and vagus nerves has allowed us to define specific values based on differential excitabilities, but has precluded voice fluency because of focused breaks during stimulation and the need to treat several neural conduits. Such problems may be obviated by a circuit capable of stimulating some axons while simultaneously blocking others in the recurrent laryngeal nerve, which carries innervation to all intrinsic laryngeal muscles, including the arguably intrinsic cricothyroideus. In 5 dogs, both recurrent laryngeal nerves received 40-Hz quasi-trapezoidal pulses (0 to 2000 microA, 0 to 2000 micros, 0 to 500 micros decay) via tripolar electrodes. Electromyograms were matched with audio intensities and fundamental frequencies recorded under a constant flow of humidified air. Data were digitized and evaluated for potential correlations.
Orderly recruitment of the thyroarytenoideus, posterior cricoarytenoideus, and cricothyroideus was correlated with stimulating intensities (p < .001), and posterior cricoarytenoideus opposition to the thyroarytenoideus and cricothyroideus was instrumental in manipulating audio intensities and fundamental frequencies.
Manipulation of canine voice parameters appears feasible via the sole recurrent laryngeal nerve within appropriate stimulation envelopes, and offers promise in human laryngeal dystonias.
我们推测，语音可能会被人为操控，以改善那些被认为是竞争性神经肌肉系统之间动态整合失败的肌张力障碍。
通过喉返神经和迷走神经进行阳极阻滞来有序地募集喉内固有肌，这使我们能够根据不同的兴奋性来确定特定值，但由于刺激过程中的集中中断以及需要治疗多条神经导管，因此无法实现语音流畅性。能够刺激喉返神经中的一些轴突同时阻断其他轴突的电路可以避免这些问题，喉返神经为包括可视为固有肌的环甲肌在内的所有喉内固有肌提供神经支配。在5只犬中，通过三极电极向双侧喉返神经施加40赫兹的准梯形脉冲（0至2000微安，0至2000微秒，0至500微秒衰减）。在恒定的湿化空气流条件下，将肌电图与记录的音频强度和基频进行匹配。对数据进行数字化处理并评估潜在的相关性。
甲杓肌、后环杓肌和环甲肌的有序募集与刺激强度相关（p < .001），后环杓肌与甲杓肌和环甲肌的对抗有助于操控音频强度和基频。
在适当的刺激范围内，通过单独的喉返神经操控犬的语音参数似乎是可行的，并且在人类喉肌张力障碍方面具有前景。
