Use of Direct Posterior Cricoarytenoid Stimulation in Laryngeal Paralysis

Abstract

There are several methods used to restore impaired respiratory and phonatory function to the paralyzed larynx; but none are satisfactory. After we critically reviewed all available methods, we proposed a technique to rehabilitate the bilaterally paralyzed larynx, using selective stimulation of the posterior cricoarytenoid (PCA) muscle. This technique has the following advantages over existing methods: (1) preservation of phonation, (2) less chance of aspiration than with arytenoidectomy, and (3) reversibility. Adaptation of existing biomedical technology used in conjunction with any of several methods of triggering with respiration would make this a practical method. After insertion of electrodes into the PCA muscle of anesthetized animal subjects, selective electrical stimulation of this muscle was successfully accomplished. A significant reproducible increase in glottic area was demonstrated. Applicability to those suffering from bilateral laryngeal denervation seems feasible and functionally superior to existing methods of rehabilitation.