Abstract

One of the most common causes for larynx paralysis is the injury of the recurrent laryngeal nerve which, among others, causes the paralysis of the posterior cricoarytenoideus muscle (PCA). Electrical stimulation of PCA offers an approach to retaining the function of the paralyzed larynx muscle. The study aim was to test the applicability of an intramuscular multichannel array electrode as a measuring electrode for myoelectrical potentials and as a possible electrode for stimulation, e.g., posterior cricoarytenoideus muscle stimulation. For this purpose, two different kinds of electrodes were compared. 42 intramuscular multichannel array electrodes and 11 supramysial multichannel electrodes were implanted into the triceps brachii muscle of rats. The triceps brachii muscle of rats is suitable to serve as a substitute muscle for the human PCA muscle in an in vivo animal model. It has the same striated muscle cells, is of comparable size, and fundamentally serves a similar function to the human PCA muscle during normal respiration. Walking and breathing are circular functions that cause minimal muscle fatigue when carried out steadily. In total, the myoelectrical activity of 6703 steps could be recorded, allowing a comparison and statistical analysis of the EMG amplitudes and EMG activation patterns. Small differences can be detected between the EMG signals of both electrode types which, however, can be explained physiologically. Both electrode types reveal the basic characteristics of the triceps brachii muscle activity, namely the muscle contraction strength and the coordination pattern. This indicates that the intramuscular electrode may be applied for a detailed analysis of the human larynx.

Highlights

  • The paired posterior cricoarytenoid (PCA muscle) in humans is the only muscle that is responsible for the opening of the glottis [1,2]

  • The first statistical test conducted was to determine to what extent the eight electrode surfaces of each muscle belly coincide with respect to the normalized step

  • The tested parameters are highly reliable, having a correlation coefficient of r > 0.9 [12]. This result permitted to mean the values of eight electrode surfaces for each muscle belly

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Summary

Introduction

The paired posterior cricoarytenoid (PCA muscle) in humans is the only muscle that is responsible for the opening of the glottis [1,2]. The paralysis of this muscle causes a disturbed voice function, aspiration and shortness of breath. Electrical stimulation could serve as a temporary measure to maintain muscle strength (contractility) and motility of the paralyzed laryngeal muscles to onset of spontaneous reinnervation, and as a permanent solution in case of non-occurrence of reinnervation. The laryngeal EMG of the PCA muscle serves to determine the innervation condition of the larynx in case of vocal cords paralysis. EMG measurements allow to draw conclusions about the causes of the vocal cords paralysis. The myoelectrical activity of the inner larynx muscles is measured with the patient awake and under local anesthesia, generally induced endolaryngeally via bipolar hooked-wire electrodes [4,5,6] and in some cases transcutaneously via the ligamentum conicum, using a concentric bipolar needle electrode

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