Vocal Fold Paresis and Paralysis

Colorful SEM photoPrincipal Investigator: Rick Roark, Ph.D.

Enrollment: Open 

Objective: Paralysis of the recurrent and superior laryngeal nerves can suffer damage due to surgery, disease, or unknown reasons. To develop a clinical plan for remediation of laryngeal function, it is very helpful to determine if the nerve will recover, and to do so as early as possible. If nerve recovery can be predicted, then remediation surgery might be avoided - and vice versa. The goal of this study is to develop improved prognostic technologies for patients having paresis and paralysis of laryngeal nerves. Studies involving facial nerves is likewise underway in the Department.  

Overview: The Department is co-recipient of a Bioengineering Research Partnership (Program Project) with Boston University to develop and implement a new clinical instrument to perform functional neural imaging via electromyography. Our Department will be applying the new technology to a clinical population having unilateral vocal fold paresis for the purpose of improving prediction of recovery (prognosis), which has historically proven difficult for this clinical condition. The study is funded by the National Institutes of Health. Dr. Rick Roark is a Co-Principal Investigator of the project.

Other Co-Principal Investigators of the five-year study include Dr. Mario Manto of the Free University of Brussels, applying the neural imaging technology to patients with cerebellar stroke; Dr. Zeynep Erim at the Rehabilitation Institute of Chicago, studying neural control changes in the aged population; and Principal Investigator Dr. Carlo De Luca of the NeuroMuscular Research Center at Boston University, examining neural control during muscle fatigue.

Departmental Co-Investigators are Steven Schaefer, M.D., James CL Li, M.D., Lucian Sulica, M.D. and Craig Zalvan, M.D. 

Eligibility: Research subjects are being recruited for this study. If you are a physician treating unilateral vocal fold paresis of known etiology, please contact Dr. Roark for participation details.

Contact Information: Rick Roark, Ph.D., (212) 979-4200

Funding: The National Institutes of Health     [Read the abstract]

Selected Publications & Presentations:

Roark RM, Li JC-L, Schaefer SD, Adam A, De Luca CJ. Multiple Motor Unit Recordings of Laryngeal Muscles: The Technique of Vector Laryngeal EMG. Laryngoscope 2002, 112:2196-2201. [Abstract]

De Luca CJ, Nawab S, Adam A, Roark R, Manto M. Precision decomposition II for EMG signals: An NIH bioengineering research project. XIVth Congress of the International Society of Electrophysiology and Kinesiology, Vienna, Austria, June 2002.

Roark, RM., Dowling EM, DeGroat RD, Watson BC, Schaefer SD. Time-Frequency analysis of thyroarytenoid myoelectric activity in normal and spasmodic dysphonia subjects, Journal of Speech and Hearing Research 1995, 38:289-303. [Abstract]

Roark RM, De Luca CJ , Schaefer SD, Li JCL, Adam A, Wong H. Multiple motor unit recordings of laryngeal myoelectric signals, 29th Annual Symposium: Care of the Professional Voice, The Voice Foundation, Philadelphia, June 2000.

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Preliminary Results:

Preliminary Results The morphology of a laryngeal motor unit: In A, firings of cranial motoneurons (MN) establish axon potentials (AP) on associated nerve axons (NA) of the recurrent laryngeal nerve, B. In C, depolarization of the multiple muscle fibers associated with the active motoneurons creates tension (force) of the thyroarytenoid muscle. In D, the quadrifilar electrode detects a vector of near-field myoelectric events as well as the conventional EMG signal of composite motor unit action potentials (MUAP).

Related Information: Other Research Projects in Neurolaryngology

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