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Vanderbilt UniversityDepartment of Biomedical Engineering
Device for Quantification of Re-Innervation of a Laryngeal Muscle
Advisor: Dr. David Zealear
Designers: Thomas Thomasson and Nirav Patel
March 24, 2000
Background•What ?- Development of a design and technique for the quantitative measurement of a re-innervated laryngeal muscle
•Why ?- To increase quality of life for patients suffering from denervated muscular system
•From? -Surgical removal of cancer growth, nerve damage, arytenoidectomy, vocal fold resection.1
•Who ? - Patients that have lost muscle control through paralysis of laryngeal muscles (2estimates of 16,000/yr in U.S., 25% having bilateral paralysis)1. Michaels, Pathology of the Larynx., 1984 2. National Center for Health Statistics, 1996.
Background Cont...
• How ?- Recording EMG readings passes through the developed circuitry while tactile stimulation of the nerves is performed
• Analysis? -Integrated recordings over time show degree of re-innervation and muscle fiber reconstruction counts
• Synkinetic Ratio- Level of Re-innervation over initial nerve signals
Background Cont...• Electrical stimulus must be performed before 7
months after denervation of laryngeal muscle--fibrosis.3
• Stimulus paradigm-- 1 second pulse train with 2msec pulses at 30 Hz with a current of 4-14mA.4
• Neuromuscular block, Botox, suppresses adductor movement allowing greater abductor movement (7mm dynamic opening)5
3,4,5 - Zealear, Billante. Emerging Approaches to Laryngeal Rehabilitation
Objectives• To Measure electromyographical potentials using
electrodes.
• To establish an index of synkinesis that compares pathological nerve re-innervation to normal nerve alignment
• To use index of synkinesis to determine severity of pathology.
• To measure muscle fiber bundles that have been re-innervated (secondary measurement of paralysis severity)
Circuit
•High Pass Filter
•Removes DC noise and low frequency AC noise
•Low Pass Filter
•Cutoff frequency of 100K Hz
•Rectifier
•Returns absolute value of input•Positive Wave Rectifier: Vout = Vin •Diodes Act Linearly in Feedback Loop
Circuit Cont...
• Integrator
– Calculates area under input curve
– Integrates the Rectified Wave Over Time by the equation: Vout = -1/(Rf Cf ) Vin dt
• Peak Detector
– Holds maximum value from the integrator
Circuit Output
Input Signal
Rectified Signal
Integrated Signal/ Peak Value
EMG Signals From Dog Subjects
Signal From Indirect Stimulation of Nerve
Signal From Direct Stimulation of Nerve
Design Implementations• Researched and Designed Circuit for
optimal performance
• Circuit Components selected based on effectiveness and cost efficiency– voltage limitations for powering op amp– minimize DC noise within op amps
• Potentiometer added in Circuit Design for Calibration that will be performed with a 2Vp-p 1kHz sine wave
DesignSafe Analysis
• Circuit Components Shorting – Design Around Hazard While Hard Wiring
• Overloading Circuit – Add Neon Bulb between input Electrodes
• Direct/Indirect Contact With Live Wires– Design Around By Properly Insulating Circuit
and Components
Current Work
• Begin Hard Wiring Circuit onto a Vector Board
• Debug the Vector Board
• Add a digital output meter, which has been ordered, to the circuit to serve as a final output source
Future Work• Use circuit during canine experiments
• Development of index of synkinesis through statistical analysis upon completion of canine experiments
• Begin Poster presentation design