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Hadley LaryngoTracheal Control.pdf (2.57 MB)

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Dynamic Laryngo-Tracheal Control for Airway Management in Dysphagia

Hadley, Aaron John
http://rave.ohiolink.edu/etdc/view?acc_num=case1370591910

Abstract Details

2013, Doctor of Philosophy, Case Western Reserve University, Biomedical Engineering.
Control of the laryngo-tracheal opening is necessary to balance the body’s constant need of oxygen, phonate speech, and enable safe intake of food. A common result of traumatic brain injury and stroke is paralysis and paresis of the vocal folds, causing impaired breathing, hoarseness, and aspiration. Vocal fold adduction and laryngeal elevation serve as protective mechanisms to divert fluids and food away from the airway and into the esophagus during deglutition. The aims of the current study were to: 1) Examine selective hypoglossal nerve stimulation for laryngeal elevation, 2) Optimize the stimulation angles and parameters of transtracheal stimulation, and 3) Develop an automatic detection algorithm using natural signals from swallowing. Hypoglossal nerve stimulation induced laryngeal elevation to a magnitude approximately equal to that of a natural swallow, and FINE electrodes were shown to be able to selectively activate the muscles of elevation. Transtracheal stimulation, when applied at the optimized angles, was able to induce complete vocal fold adduction. A time-delay artificial neural network was trained to sensitively and selectively detect swallowing using oral pressure signals. This research advances the creation of a closed-loop laryngeal stimulator for dysphagia protection by assessing novel stimulation paradigms, producing an automatic control signal, and combining laryngeal stimulation measures for more complete protection. The results of this research strongly support advancing these techniques to pilot clinical trials.
Dustin Tyler , PhD (Committee Chair)
Kenneth Gustafson, PhD (Committee Member)
Michael Broniatowski, M.D. (Committee Member)
Patrizia Bonaventura, PhD (Committee Member)
159 p.
Biomedical Engineering; Rehabilitation
Larynx; swallowing; functional electrical stimulation; pattern detection; palatometry; hypoglossal nerve; laryngeal elevation; vocal folds; transtracheal stimulation

Recommended Citations

Citations

  • Hadley, A. J. (2013). Dynamic Laryngo-Tracheal Control for Airway Management in Dysphagia [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1370591910

    APA Style (7th edition)

  • Hadley, Aaron. Dynamic Laryngo-Tracheal Control for Airway Management in Dysphagia. 2013. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1370591910.

    MLA Style (8th edition)

  • Hadley, Aaron. "Dynamic Laryngo-Tracheal Control for Airway Management in Dysphagia." Doctoral dissertation, Case Western Reserve University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1370591910

    Chicago Manual of Style (17th edition)

case1370591910
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© 2013, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.