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81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

12.05. - 16.05.2010, Wiesbaden

Laryngeal pacemaker – acute and chronic electrode implantations in pig larynx

Meeting Abstract

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German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hno003

DOI: 10.3205/10hno003, URN: urn:nbn:de:0183-10hno0036

Published: July 6, 2010

© 2010 Förster et al.
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Outline

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Introduction: In patients with bilateral recurrent laryngeal nerve paralysis (B-RLNP) and at least unilateral syncinetic re-innervation an electrical pacing of the posterior cricoarytenoid muscle (PCA) could become an option for improving breathing in foreseeable future. An important aspect in the concept of laryngeal pacing is an accurate and atraumatic electrode insertion.

Material and method: Between 2007 and 2009 tests for electrode insertion were carried out in 16 domestic piglets and 2 Göttingen mini pigs with intact laryngeal innervation. With specially designed insertion tools and constant electrical stimulation optimal locations for electrode insertion were identified. Glottal opening in relation to stimulus strength and stimulation site were documented. A lateral approach and a medial subglottic submembraneous transcricoidal way were used.

Results: With the new insertion techniques it was possible to place electrodes accurately at sensitive spots within the PCA. Thresholds were between 0.1 and 1.5 mA as expected for direct nerve stimulation protocols. Currencies for optimal glottal opening were marginally higher in most cases. Optimal electrode positions were mainly in the lower outer quadrant of the PCA.

Conclusions: These tests considerably promoted the development of a targeted minimal invasive electrode insertion into the PCA for laryngeal pacing. Effective tools were designed. Further tests will concentrate on long term stability of the electrodes and their anchoring within the tissue.