Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.
Laryngoscope. 2021 Sep;131(9):E2566-E2572. doi: 10.1002/lary.29538. Epub 2021 Apr 2.
Selective electrical surface stimulation (SES) of the larynx is not yet routinely considered therapy option in treatment of unilateral vocal fold paralysis (UVFP). Goal of this monocentric feasibility study was to provide systematic data on applicability of SES of intrinsic laryngeal muscles in UVFP under consideration of sensitivity and discomfort thresholds and nonselective side effects.
Thirty-two UVFP patients were included in the study. Symmetric triangular-shape, charge-balanced pulse widths (PWs) of 1, 10, 25, 50, 100, 250, and 500 milliseconds (ms) were tested with increasing amplitudes (AMPs). The stimulation was delivered as a train of five pulses using square surface electrodes. Selective laryngeal responses were examined by flexible laryngoscopy. Nonselective side effects (swallowing reflex, coughing, different severity degrees of unspecific strap muscle/platysma response) were judged by observation.
Selective laryngeal response could be triggered in 28/32 (87.5%) patients during respiration/rest and in 26/32 (81.3%) patients during phonation. The most effective PWs for the selective eliciting of selective bilateral vocal fold adduction are comprised between 50 and 100 ms in combination with an average AMP comprised between 7.1 and 7.2 mA.
Our results indicate that, in UVFP patients, PWs comprised between 50 and 100 ms in combination with a median AMP between 7.1 and 7.2 mA are expected to deliver in >75% of the cases a specific, effective, and safe bilateral adduction of the VF.
3 Laryngoscope, 131:E2566-E2572, 2021.
选择性电表面刺激（SES）喉尚未常规考虑治疗单侧声带麻痹（UVFP）的选择。本单中心可行性研究的目的是提供关于内在喉肌 SES在 UVFP 中的适用性的系统数据，同时考虑敏感性和不适阈值以及非选择性副作用。
32 例 UVFP 患者纳入本研究。采用对称三角形、平衡电荷的脉冲宽度（PW）为 1、10、25、50、100、250 和 500 毫秒（ms），并逐渐增加幅度（AMP）进行测试。刺激通过使用方表面电极以五个脉冲的串形式传递。通过纤维喉镜检查检查选择性喉反应。通过观察判断非选择性副作用（吞咽反射、咳嗽、不同严重程度的非特异性颈阔肌/胸锁乳突肌反应）。
在呼吸/休息期间，28/32（87.5%）例患者和在发声期间，26/32（81.3%）例患者可触发选择性喉反应。诱发选择性双侧声带内收的最有效 PW 为 50-100ms，结合平均 AMP 为 7.1-7.2mA。
我们的结果表明，在 UVFP 患者中，50-100ms 的 PW 结合 7.1-7.2mA 的中位数 AMP 预计将在>75%的情况下提供有效的、安全的双侧 VF 内收。
3 级喉镜，131：E2566-E2572，2021 年。
