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Functional Electrical Stimulation for Treatment of Equine Naturally-occurring RLN: Long Term Results and Potential of Combined Re-innervation
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Introduction
Laryngoplasty is the most common surgical treatment of recurrent laryngeal neuropathy (RLN). This gold standard technique is nevertheless associated with potential complications as prosthesis failure, persistent cough, postoperative dysphagia or neurologic pharyngeal dysfunction.
Those complications have led to the development of research programs in the field of functional restoration of the laryngeal function.
Functional electrical stimulation (FES) is the application of electrical stimulation through devices (i.e. neuroprosthesis) with the objective to rehabilitate neurologic deficits, restore muscle mass and force, and improve fatigue resistance. Functional electrical stimulation (FES) of the crico-arytenoideus dorsalis muscle (mCAD) allows to preserve muscle fiber excitability and contractile strength. Previously it has been shown that FES can provide an appropriate arytenoid abduction in horses through direct recurrent laryngeal nerve stimulation or stimulation through an intra-muscular electrode at rest and during strenuous exercise.
On the other hand, treatment of vocal fold paralysis through selective motor reinnervation has been described with variable techniques and results in different animal species and in human patients. Recent experimental work has demonstrated the interest of electrical stimulation of a nerve distal stump after transection, with promotion of motoneuron regeneration and earlier functional recovery. Combination of FES and surgical reinnervation of the mCAD is currently being investigated in naturally occurring laryngeal hemiplegia in the horse. [...]
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