Electrode Array Reanimation of the Paralyzed Larynx

描述（由申请人提供）：本项目的总体目标是在动物模型中建立一种可靠的麻痹喉部复活方法。本研究的最终方向是开发一种用于恢复声带瘫痪后喉功能的人体植入装置。驱动这个项目的假设是，植入电极阵列在周围喉返神经（RLN）可以选择性地刺激喉内收肌和外展肌。这个原理可以用来设计一种装置，使瘫痪的声带恢复活力，恢复喉部发声和呼吸的功能。因此，主要的结果变量是恢复声带内收肌和外展肌的生理性运动。在实现这些目标的工作中，一个完善的喉麻痹猫模型被用来探索该装置的潜在应用。本课题的具体目的包括：1)确定电极阵列可植入区域RLN内神经纤维的地形取向；2)确定电极阵列刺激RLN在RLN-RLN神经成像和ansa-RLN神经成像两种手术条件下在动物声带麻痹模型中选择性恢复声带运动的可行性；3)确定电极阵列植入RLN的长期稳定性。为了达到这些目的，外科手术将在神经缺损愈合后的动物模型和植入的电极阵列中进行。选择性刺激电极阵列，通过喉镜和喉肌电图观察声带内收肌和外展肌的运动和激活情况。电极阵列固定并连接到安装在头部的外部基座上。这允许连续电极刺激和观察喉部运动在一个延长的时间长度。神经样本将被收集和研究，以检查植入阵列对RLN纤维的影响。

DESCRIPTION (provided by applicant): The overall goal of this project is to establish a reliable means of reanimation of the paralyzed larynx in an animal model. The eventual direction of this research is to develop a device for human implantation to restore laryngeal function after vocal fold paralysis. The hypothesis driving this project is that an implanted electrode array in the peripheral recurrent laryngeal nerve (RLN) can selectively stimulate laryngeal adductor muscles and abductor muscles. This principle can then be used to design a device that will reanimate a paralyzed vocal fold and restore laryngeal functions of phonation and respiration. Thus, the major outcome variable is to restore physiologic adductor and abductor vocal fold movement. In work toward these goals, a well-established cat model of laryngeal paralysis is used to explore the potential applications of this device. The specific aims of this proposal include: 1) Determine the topographic orientation of the nerve fibers in the RLN in the region where an electrode array can be implanted, 2) Determine the feasibility of selective reanimation of vocal fold movement in an animal vocal fold paralysis model by electrode array stimulation of the RLN in two surgical conditions of RLN-RLN neurorraphy, and ansa-RLN neurorraphy, and 3) Determine the long-term stability of electrode array implant in the RLN. To accomplish these aims, the surgical procedures will be performed in the animal model and electrode array implanted after the neurorraphy has healed. The electrode array is selectively stimulated, laryngoscopy and laryngeal EMG is performed to observe for vocal fold adductor and abductor movement and activation. The electrode array is secured and wired to an external pedestal mounted on the head. This allows serial electrode stimulation and observations of laryngeal movement over an extended length of time. Nerve samples will be harvested and studied to examine the effects of the implanted array on RLN fibers.