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Pacemaker for larynx allows patients to breathe easier

Doctors at Vanderbilt University Medical Center have developed a new implantable device that helps patients with paralyzed vocal folds breathe on their own.

The new device for bilateral paralysis of the larynx is an Implantable Pulse Generator (IPG) that allows a patient to speak and breathe normally. The device was recently implanted, for the first time ever in the United States, in a Missouri woman.

"We are excited about the possibilities with this electrical pacing device," said David L. Zealear, Ph.D., associate professor of Otolaryngology and director of research in the department. "The idea is to restore the opening function of the larynx to allow inhaling and exhaling necessary to normal breathing. We are able to restore that function."

With the device, Zealear says, an electrode is inserted next to the opening muscle of the larynx sandwiched between the cricoid cartilage and the muscle. "It involves electrical stimulation of the critical laryngeal muscle that has been paralyzed. The stimulation is done at the precise moment that the patient inhales, allowing the patient to take a breath," Zealear said. The lead wire from the electrode is then brought subcutaneously through a tunnel to an incision below the clavicle. A pocket is made at that incision site and the stimulator is placed in that pocket. It can be re-programmed through the skin by using a microprocessor, Zealear said. "When the stimulus is discontinued, the muscles passively relax back to their midline position to allow normal voice production and airway protection."

Zealear says about 6,000 patients are stricken with bilateral laryngeal paralysis each year in the United States. The condition is created primarily when the two nerves that serve the larynx become paralyzed due to neck surgery. "Both the opening and closing functions are lost on both sides. The patient can not breathe and is in a life-threatening situation. For acute paralysis, the patient must have an emergen
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Contact: Matt Scanlan
matt.scanlan@mcmail.vanderbilt.edu
615-322-4747
Vanderbilt University Medical Center
21-Sep-1999


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