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Bilateral Functional Electrical Stimulation for the Treatment of Presbyphonia in a Sheep Model

Kirsch, A; Gerstenberger, C; Jakubass, B; Tschernitz, M; Perkins, JD; Groselj-Strele, A; Lanmueller, H; Jarvis, JC; Kniesburges, S; Doellinger, M; Gugatschka, M


A Kirsch

C Gerstenberger

B Jakubass

M Tschernitz

JD Perkins

A Groselj-Strele

H Lanmueller

JC Jarvis

S Kniesburges

M Doellinger

M Gugatschka


Objectives: The aim of the study was to increase muscle volume and improve phonation characteristics of the aged ovine larynx by functional electrical stimulation (FES) using a minimally invasive surgical procedure. Methods: Stimulation electrodes were placed bilaterally near the terminal adduction branch of the recurrent laryngeal nerves (RLN). The electrodes were connected to battery powered pulse generators implanted subcutaneously at the neck region. Training patterns were programmed by an external programmer using a bidirectional radio frequency link. Training sessions were repeated automatically by the implant every other day for 1 week followed by every day for 8 weeks in the awake animal. Another group of animals were used as sham, with electrodes positioned but not connected to an implant. Outcome parameters included gene expression analysis, histological assessment of muscle fiber size, functional analysis, and volumetric measurements based on three-dimensional reconstructions of the entire thyroarytenoid muscle (TAM). Results: Increase in minimal muscle fiber diameter and an improvement in vocal efficiency were observed following FES, compared with sham animals. Conclusion: This is the first study to demonstrate beneficial effects in the TAM of FES at molecular, histological, and functional levels. FES of the terminal branches of the RLN reversed the effects of age-related changes and improved vocal efficiency.


Kirsch, A., Gerstenberger, C., Jakubass, B., Tschernitz, M., Perkins, J., Groselj-Strele, A., …Gugatschka, M. (2023). Bilateral Functional Electrical Stimulation for the Treatment of Presbyphonia in a Sheep Model. The Laryngoscope,

Journal Article Type Article
Acceptance Date Aug 3, 2023
Online Publication Date Aug 19, 2023
Publication Date 2023
Deposit Date Sep 6, 2023
Publicly Available Date Sep 6, 2023
Print ISSN 0023-852X
Publisher Wiley
Peer Reviewed Peer Reviewed
Keywords aged larynx; functional electrical stimulation; vocal fold atrophy; PARALYZED CANINE LARYNX; VOCAL FOLD PARALYSIS; MUSCLE; VOICE; REHABILITATION; YOUNG


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