{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:22:43Z","timestamp":1777422163553,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2010,3,1]],"date-time":"2010-03-01T00:00:00Z","timestamp":1267401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"},{"start":{"date-parts":[[2010,3,1]],"date-time":"2010-03-01T00:00:00Z","timestamp":1267401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We undertook to determine whether paced vocal fold adduction can check aspiration in patients with various neurologic conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five patients with fluoroscopically documented aspiration and repeated pneumonias were enrolled. Two previously reported patients with hemispheric stroke were compared to 3 additional subjects with brain stem-basal ganglia and cerebellar stroke, cerebral palsy, and multiple sclerosis. A modified Vocare stimulator was implanted subcutaneously and linked to the ipsilateral recurrent laryngeal nerve via perineural electrodes. Vocal fold adduction and glottic closure were effected with pulse trains (42 Hz; 1.2 mA; 188 to 560 us) and recorded with Enhanced Image J. Fluoroscopy results with and without stimulation were assessed by 2 independent blinded reviewers. Pneumonia rates were compared before, during, and after the 6- to 12-month enrollment periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was statistically significant vocal fold adduction (p &lt; 0.05) for all patients, further verified with bolus arrest (p &lt; 0.05 for thin liquids, thick liquids, and puree depending on the speech-language pathologist). Pneumonia was prevented in 4 of the 5 patients during enrollment. In the fifth patient, who had brain stem-basal ganglia and cerebellar stroke, we were unable to completely seal the glottis and open the cricopharyngeus enough to handle his secretions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vocal fold pacing for aspiration pneumonia from a variety of neurologic insults appears to be appropriate as long as the glottis can be sealed. It is not sufficient when the cricopharyngeus must be independently opened.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/000348941011900301","type":"journal-article","created":{"date-parts":[[2017,5,30]],"date-time":"2017-05-30T05:07:14Z","timestamp":1496120834000},"page":"141-149","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Paced Glottic Closure for Controlling Aspiration Pneumonia in Patients with Neurologic Deficits of Various Causes"],"prefix":"10.1177","volume":"119","author":[{"given":"Michael","family":"Broniatowski","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Case Western-Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina Z.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Grundfest-Broniatowski","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey M.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Case Western-Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Lancaster","sequence":"additional","affiliation":[{"name":"St Vincent Charity Hospital, University Hospitals Health System, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Krival","sequence":"additional","affiliation":[{"name":"School of Speech Pathology and Audiolgy. Kent State University, Kent, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron J.","family":"Hadley","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dustin J.","family":"Tyler","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,5,30]]},"reference":[{"key":"bibr1-000348941011900301","first-page":"1","author":"ECRI Health Technology Assessment Group.","year":"1999","journal-title":"Evid Rep Technol Assess (Summ)"},{"key":"bibr2-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1007\/BF00261272"},{"key":"bibr3-000348941011900301","volume-title":"Management of adult neurogenic dysphagia.","author":"Huckabee ML","year":"1999"},{"key":"bibr4-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1007\/BF00431414"},{"key":"bibr5-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00395.2002"},{"key":"bibr6-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200111000-00031"},{"key":"bibr7-000348941011900301","first-page":"31","volume":"58","author":"Carnaby-Mann G","year":"2007","journal-title":"North East Florida Med"},{"key":"bibr8-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-005-0034-9"},{"key":"bibr9-000348941011900301","volume-title":"PDQ Statistics, &s 4 (parametric statistics) and 9 (non-parametric statistics).","author":"Norman GR","year":"1986"},{"key":"bibr10-000348941011900301","first-page":"825","volume":"86","author":"Kidd D","year":"1993","journal-title":"Q J Med"},{"key":"bibr11-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-003-0019-4"},{"key":"bibr12-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1933.106.3.524"},{"key":"bibr13-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1177\/000348940211100611"},{"key":"bibr14-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1007\/s004550010001"},{"key":"bibr15-000348941011900301","first-page":"973","volume":"74","author":"Johnson ER","year":"1993","journal-title":"Arch Phys Med Rehab"},{"key":"bibr16-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.9.5.466"},{"key":"bibr17-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(02)00053-7"},{"key":"bibr18-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0404.2002.10062.x"},{"key":"bibr19-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1177\/154596839701100102"},{"key":"bibr20-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009579"},{"key":"bibr21-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2008.06.001"},{"key":"bibr22-000348941011900301","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.1.223"}],"container-title":["Annals of Otology, Rhinology &amp; Laryngology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/000348941011900301","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/000348941011900301","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:19:14Z","timestamp":1777375154000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/000348941011900301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2010,3]]}},"alternative-id":["10.1177\/000348941011900301"],"URL":"https:\/\/doi.org\/10.1177\/000348941011900301","relation":{},"ISSN":["0003-4894","1943-572X"],"issn-type":[{"value":"0003-4894","type":"print"},{"value":"1943-572X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3]]}}}