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Vanderbilt University Department 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

Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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Page 1: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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

Page 2: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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.

Page 3: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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

Page 4: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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

Page 5: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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)

Page 6: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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

Page 7: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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

Page 8: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

Circuit Output

Input Signal

Rectified Signal

Integrated Signal/ Peak Value

Page 9: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

EMG Signals From Dog Subjects

Signal From Indirect Stimulation of Nerve

Signal From Direct Stimulation of Nerve

Page 10: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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

Page 11: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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

Page 12: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

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

Page 13: Vanderbilt University Department of Biomedical Engineering Device for Quantification of Re-Innervation of a Laryngeal Muscle Advisor: Dr. David Zealear

Future Work• Use circuit during canine experiments

• Development of index of synkinesis through statistical analysis upon completion of canine experiments

• Begin Poster presentation design