Electrode Array Reanimation of the Paralyzed Larynx

描述(由申请人提供)：该项目的总体目标是在动物模型中建立一种可靠的喉瘫痪复活方法。这项研究的最终方向是开发一种用于人类植入的装置，以恢复声带瘫痪后的喉功能。这个项目背后的假设是，在周围喉返神经(RLN)中植入电极阵列，可以选择性地刺激喉内收肌和外展肌。然后，这一原理可以用来设计一种设备，使瘫痪的声带恢复活力，恢复喉咙的发声和呼吸功能。因此，主要的结果变量是恢复生理性的内收肌和外展肌声带运动。在为实现这些目标所做的工作中，我们使用了一个公认的喉部麻痹的猫模型来探索该设备的潜在应用。该方案的具体目的包括：1)确定可植入电极阵列的区域内喉返神经内神经纤维的定位；2)确定在两种手术条件下，通过电极阵列刺激喉返神经选择性恢复声带运动的可行性；(3)确定电极阵列植入喉返神经的长期稳定性。为了实现这些目标，在神经造影术愈合后，将在动物模型和植入的电极阵列中进行外科手术。选择性刺激电极阵列，喉镜和喉部肌电图观察声带内收肌和外展肌的运动和激活情况。电极阵列被固定并连线到安装在磁头上的外部基座。这使得连续电极刺激和在更长时间内观察喉部运动成为可能。将采集神经样本并进行研究，以检查植入的阵列对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.