{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T01:45:45Z","timestamp":1767923145892,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,7,23]],"date-time":"2019-07-23T00:00:00Z","timestamp":1563840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Standard stimulating methods using square waves do not appropriately restore physiological control of individual intrinsic laryngeal muscles (ILMs). To further explore our earlier study of evoked orderly recruitment by quasitrapezoidal (QT) currents, we integrated the contribution of the cricothyroideus (CT) with attention to mutual activation in an additional patient, based on recent studies of appropriate responses via strict recurrent laryngeal nerve (RLN) stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Basic science study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The patient received functional electrical stimulation (FES) with QT pulses at 5 Hz, 60 to 2,000 \u03bcAmp, 100 to 500 \u03bcs pulse width, 0 to 500 \u03bcs decay. Ipsilateral electromyography (EMG) responses were calculated using the average maximum amplitude, area under the curve, and the root mean square of the rectified amplitude waveforms. The thyroarytenoideus (TA), posterior cricoarytenoideus (PCA), lateral cricothyroideus (LCA), and the CT were each interrogated via two monopolar electrodes, values were recorded in MATLAB, exported to Excel, and analyzed. Individual and mutual recruitment configurations and activation delays with stimulation were explored using multiple regression and exploration factor analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 868 EMG data points based on 18 trials and up to 11 subtrials were captured from each of the four ILMs. Various combinations of pulse amplitude, pulse width, and exponential decay were found to produce significant (<jats:italic>P<\/jats:italic> \u2264\u2009.001) individual ILM responses. CT mirrored the LCA, whereas the TA and PCA exhibited separate interactions along shared trajectories in a three\u2010dimensional space.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>FES calibrated to individual and coupled ILMs offers promise for restoring normal and pathological contraction patterns via strict RLN stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>5 <jats:italic>Laryngoscope<\/jats:italic>, 130:967\u2013973, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28184","type":"journal-article","created":{"date-parts":[[2019,7,23]],"date-time":"2019-07-23T15:37:23Z","timestamp":1563896243000},"page":"967-973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Selective stimulation of human intrinsic laryngeal muscles: Analysis in a mathematical three\u2010dimensional space"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1206-0927","authenticated-orcid":false,"given":"Michael","family":"Broniatowski","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery MetroHealth Medical Center, Case Western Reserve University School of Medicine  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Grundfest\u2010Broniatowski","sequence":"additional","affiliation":[{"name":"Department of General Surgery Cleveland Clinic Foundation  Cleveland Ohio"},{"name":"Cleveland Clinic Foundation Lerner College of Medicine Case Western Reserve University School of Medicine  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Schiefer","sequence":"additional","affiliation":[{"name":"Advanced Platform Technology Center Louis Stokes Cleveland Veterans Affairs Medical Center  Cleveland Ohio"},{"name":"Department of Biomedical Engineering Case Western Reserve University  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David H.","family":"Ludlow","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery MetroHealth Medical Center, Case Western Reserve University School of Medicine  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Broniatowski","sequence":"additional","affiliation":[{"name":"Department of Engineering Management and Systems Engineering George Washington University  Washington DC U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey M.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery MetroHealth Medical Center, Case Western Reserve University School of Medicine  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,23]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"546","volume-title":"Scientific Foundations of Otolaryngology","author":"Wyke BD","year":"1976"},{"key":"e_1_2_7_3_1","unstructured":"SasakiC.Anatomy and development and physiology of the larynx. Goyal and Shaker GI Motility Online website. Available at:https:\/\/www.nature.com\/gimo\/contents\/pt1\/full\/gimo7.html. Published May 16 2006. Accessed March 14 2019."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1965.28.3.560"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1933.106.3.524"},{"key":"e_1_2_7_6_1","unstructured":"SennW WylerHP ClamannJ et al. Recruitment by size and principle of least action. Technical report. Available at:https:\/\/pdfs.semanticscholar.org\/4c01\/f1e427cd65a16c6bc53fac3257b0355eb669.pdf. Published July1995. Last accessed 9 July 2019."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989310900612"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.1987.326037"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1109\/10.30809"},{"key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.3928\/0147-7447-19840801-11","article-title":"Studies towards spasticity suppression with high frequency electrical stimulation","volume":"7","author":"Solomonow H","year":"1984","journal-title":"Orthopedics"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1109\/10.76383"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1109\/10.76384"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940711600211"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23464"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22340"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25691"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199307000-00005"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1088\/1741-2560\/4\/3\/005"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200111000-00031"},{"key":"e_1_2_7_20_1","first-page":"809","article-title":"Electromyography of the cricoarytenoid unit during supracricoid laryngectomy with a cricohyoidoepiglottopexy procedure","volume":"121","author":"Nakayama M","year":"2006","journal-title":"J Laryngol Otol"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/195712b0"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940211100611"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940411300802"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.28184","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T02:21:15Z","timestamp":1694053275000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.28184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,23]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1002\/lary.28184"],"URL":"https:\/\/doi.org\/10.1002\/lary.28184","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,23]]},"assertion":[{"value":"2019-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}