Electrical Stimulation for Vocal Fold Paralysis

Michael Broniatowski

Introduction 203

Background and Justification 203

The Problem 203

Critique ofTraditional Management ofLaryngealParalyses 204

Physiological Bases for Laryngeal Stimulation 204

Challenges in Approaches to Laryngeal Stimulation 205

Laryngeal Stimulating Strategies 207

Issues of Long-Term Stimulation and Biocompatibility of Implanted

Circuits 207

Current Human Applications 207

Dynamic Laryngotracheal Closure for Aspiration 208

Dynamic Restoration ofLaryngeal Patency After Bilateral Vocal Fold Paralysis 209 PotentialFutureHumanApplications. . . . 212 IntegratedSwallowingRehabilitation. . . 213

LaryngealTransplantation 213

Artificial Control ofVoice and Spasm 213

Conclusion 215

Chapter 13

Bilateral Medialization Laryngoplasty

Gregory N. Postma, Peter C. Belafsky

Introduction 219

Surgical Indications 219

SurgicalTechnique 219

Results 222

Complications 222

Discussion 222

Approach to Surgical Treatment 223

Conclusion 223

Chapter 14

Vocal Fold Paralysis in Children

Marshall E. Smith

Introduction 225

Spectrum ofPresentation 225

The Newborn and Infant: Airway and Swallowing Assessment and Management 226

Management of Airway,Voice, and Swallowing in Vocal Fold Paralysis in Infants 227

BilateralVocal Fold Paralysis:

Long-TermManagementOptions . . . .228 Voice Concerns in the Older Child and Adolescent 229

Unilateral Laryngeal Paralysis:

ManagementOptions 230

Laryngeal EMG in Children 231

Familial Vocal Fold Paralysis 232

Conclusion 232

Chapter 15

BilateralVocal Fold Immobility

George Coding

Introduction 237

History 237

Etiology 238

Evaluation 239

Adjunctive Measures and Nonsurgical Management 240

SurgicalManagement 241

Posterior Glottic Stenosis 241

Direct Muscle Reinnervation 242

Lateralization 243

Tissue Removal 244

Research 245

Conclusion 246

Subject Index 249

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