# US 2016/0256684 A1 · Pacemaker for Unilateral Vocal Cord Autoparalysis

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- Number: US 2016/0256684 A1
- Document ID: US20160256684A1
- Status: Published application
- Kind: A1
- Application number: 15/156,885
- Filed: 2016-05-17
- Published: 2016-09-08
- Earliest claimed: 2011-12-07
- Assignees: MED-EL Elektromedizinische Geraete GmbH
- Applicants: MED-EL Elektromedizinische Geraete GmbH
- Inventors: Werner Lindenthaler
- Web page: https://patentgrep.com/patent/US20160256684A1

## CPC

- A61N 1/3606: {adapted for a particular treatment}
- A61B 5/296: for electromyography [EMG]
- A61B 5/394: specially adapted for electroglottography or electropalatography
- A61B 5/686: {Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence)}
- A61H 23/00: Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms {(apparatus for passive exercising A61H1/00; generating or transmitting mechanical vibrations in general B06B)}
- A61H 23/02: with electric or magnetic drive
- A61H 39/002: {Using electric currents (electrotherapy A61N1/32)}
- A61H 39/007: {Stimulation by mechanical vibrations, e.g. ultrasonic}
- A61N 1/0556: {Cuff electrodes}
- A61N 1/36003: {of motor muscles, e.g. for walking assistance}
- A61N 1/36053: {adapted for vagal stimulation (A61N1/36114 takes precedence)}
- A61N 1/36139: {with automatic adjustment}
- A61N 1/36171: {Frequency}
- A61H 2201/1207: with electric or magnetic drive
- A61H 2201/1253: driven by a human being, e.g. hand driven
- A61H 2201/5025: Activation means
- A61H 2201/5071: Pressure sensors
- A61H 2201/5097: wireless
- A61H 2230/605: used as a control parameter for the apparatus
- A61H 2230/655: used as a control parameter for the apparatus
- A61N 1/3601: {of respiratory organs}
- A61N 1/3611: {Respiration control (stimulating respiratory organs A61N1/3601)}
- A61N 1/36157: {Current (A61N1/3616 takes precedence)}
- A61N 1/36175: {Pulse width or duty cycle}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61H: PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY (electrotherapy, magnetotherapy, radiation therapy or ultrasound therapy A61N)

## Abstract

A method for treating a human subject having unilateral vocal cord paralysis includes sensing electrical activity of a dysfunctional muscle of the subject, generating at least one stimulation parameter, using a processor, based on the sensed electrical activity, and stimulating the dysfunctional muscle, using a stimulating electrode, based on the at least one stimulation parameter. A stimulation system is also provided.

## Claims

### Claim 1

A method of treating a human subject having unilateral vocal cord paralysis, the method comprising:
sensing electrical activity of a dysfunctional muscle of the subject;
generating at least one stimulation parameter, using a processor, based on the sensed electrical activity; and
stimulating the dysfunctional muscle, using a stimulating electrode, based on the at least one stimulation parameter.

### Claim 2 (depends on 1)

The method of claim 1, wherein the dysfunctional muscle is a synkinetically reinnervated muscle.

### Claim 3 (depends on 1)

The method of claim 1, further comprising providing the stimulating electrode configured to contact the dysfunctional muscle.

### Claim 4 (depends on 1)

The method of claim 1, wherein the stimulating electrode is configured to sense the electrical activity of the dysfunctional muscle.

### Claim 5 (depends on 1)

The method of claim 1, wherein the stimulating electrode is configured to be distal to an insertion point of a recurrent laryngeal nerve or vagus nerve into innervated muscle.

### Claim 6 (depends on 1)

The method of claim 1, wherein stimulating the dysfunctional muscle stimulates a vocalizing muscle that opens or closes a vocal fold.

### Claim 7 (depends on 6)

The method of claim 6, wherein the vocalizing muscle is selected from the group consisting of thyroarytenoid muscles, vocalis muscles, posterior cricoarytenoid muscle, lateral cricoarytenoid muscles, cricothyroid muscle and combinations thereof.

### Claim 8 (depends on 1)

The method of claim 1, wherein sensing includes detecting electromyographic (EMG) activity of a vocalizing muscle, detecting movement related to voice production, or both.

### Claim 9 (depends on 1)

The method of claim 1, further comprising:
determining when the sensed electrical activity has reached a predetermined level; and
generating the at least one stimulation parameter when the predetermined level is reached.

### Claim 10 (depends on 1)

The method of claim 1, further comprising stimulating a recurrent laryngeal nerve or vagus nerve or activating a glottic closure reflex based on the at least one stimulation parameter.

### Claim 11 (depends on 10)

The method of claim 10, wherein activating includes electrical stimulation, mechanical stimulation, or a combination thereof.

### Claim 12 (depends on 1)

The method of claim 1, wherein the at least one stimulation parameter includes a stimulation voltage that is above a threshold for activation of vocal cord adductor muscles of the subject and below a threshold for activation of vocal cord abductor muscles of the subject.

### Claim 13

A stimulation system for a human subject having unilateral vocal cord paralysis, the system comprising:
a sensing electrode configured to sense electrical activity of a dysfunctional muscle of the subject;
a processor configured to receive the sensed electrical activity of the dysfunctional muscle and configured to generate at least one stimulation parameter based on the sensed electrical activity; and
a stimulating electrode configured to stimulate the dysfunctional muscle of the subject based on the at least one stimulation parameter.

### Claim 14 (depends on 13)

The stimulation system of claim 13, wherein the processor is configured to detect when the sensed electrical activity has reached a predetermined level and configured to generate the at least one stimulation parameter when the predetermined level is reached.

### Claim 15 (depends on 13)

The stimulation system of claim 13, further comprising a manual activator configured to cause the processor to generate the at least one stimulation parameter.

### Claim 16 (depends on 13)

The stimulation system of claim 13, wherein the sensing electrode and the stimulating electrode are on the same electrode lead.

### Claim 17 (depends on 13)

The stimulation system of claim 13, wherein the at least one stimulation parameter includes a stimulation voltage that is above a threshold for activation of vocal cord adductor muscles of the subject and below a threshold for activation of vocal cord abductor muscles of the subject.

### Claim 18 (depends on 13)

The stimulation system of claim 13, wherein the sensing electrode is configured to sense electrical activity of a synkinetically reinnervated dysfunctional muscle.