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Exploring stimulation patterns for electrical stimulation of the larynx using surface electrodes.

Marlies Feiner1, C Gerstenberger2, W Mayr3

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European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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Summary

Surface functional electrical stimulation (FES) for voice disorders requires individualized patterns. This study found that no single FES pattern activated vocal folds in all participants, highlighting the need for custom-fit treatments.

Keywords:
DysphoniaLaryngeal functional electrical stimulationPresbyphoniaTranscutaneous electrical stimulationVoice rehabilitation

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Area of Science:

  • Laryngology
  • Neuromodulation
  • Speech Science

Background:

  • Functional electrical stimulation (FES) shows promise for laryngeal diseases.
  • Limited data exists on surface FES for voice disorder treatment.
  • Identifying effective FES patterns for laryngeal muscle activation is crucial.

Purpose of the Study:

  • To identify and differentiate suitable surface FES patterns for internal laryngeal muscle activation.
  • To investigate the efficacy of various FES parameters in eliciting vocal fold responses.

Main Methods:

  • Non-invasive surface FES applied to 17 elderly women.
  • Ten distinct stimulation patterns (rectangular and sawtooth) with varied frequency and amplitude were tested.
  • Vocal fold (VF) reaction was monitored using transnasal endoscopy.

Main Results:

  • Inter-individual variability in responses to FES patterns was observed.
  • No single stimulation parameter set consistently elicited a VF reaction in all participants.
  • Transnasal endoscopy confirmed varying degrees of VF response to different FES protocols.

Conclusions:

  • Individualized fitting of surface FES parameters is essential for voice disorder treatment.
  • Devices with freely programmable stimulation patterns are necessary to overcome limitations.
  • Endoscopic monitoring is critical for ensuring the effectiveness of FES interventions.