Hybrid method for modulating upper airway function in a subject
A hybrid method is provided for modulating upper airway function in a subject. The method includes applying first and second therapy signals to the subject to modulate at least one extrinsic laryngeal muscle and at least one intrinsic laryngeal muscle to synergistically control laryngeal motion and vocal fold movement, respectively.
1. A method, comprising the steps of:
delivering a first therapy signal to modulate an extrinsic laryngeal muscle of a subject according to a first timing parameter to promote anteriosuperior motion of the hyolaryngeal complex;
delivering a second therapy signal to modulate a recurrent laryngeal nerve (RLN) of the subject according to a second timing parameter to promote vocal fold closure; and
adjusting, by a controller comprising a processor, the first timing parameter of the first therapy signal and the second timing parameter of the second therapy signal, based on an input related to at least one sensed physiological signal or a volitional signal, to promote swallowing based on synergistic anteriosuperior motion of the hyolaryngeal complex and the vocal fold closure to prevent or mitigate aspiration in the subject during a swallow cycle.
2. The method of claim 1 , wherein the first therapy signal is delivered by a first electrode, and
wherein the second therapy signal is delivered by a second electrode.
3. The method of claim 1 , further comprising adjusting a strength parameter of the first therapy signal or the second therapy signal based on a sensed parameter of interest.
4. The method of claim 3 , wherein the sensed parameter of interest changes based on a volitional input.
5. The method of claim 1 , wherein the first timing parameter and the second timing parameter are adjusted to treat an upper airway disorder.
6. The method of claim 5 , wherein the upper airway disorder is at least one of a swallow cycle disorder of the subject, a laryngeal disorder of the subject, and a laryngospasm of the subject.
7. The method of claim 1 , further comprising:
sensing a change in a physiological parameter of interest; and
adjusting a strength parameter of the first therapy signal or the second therapy signal based on the sensed change in the physiological parameter of interest.
8. A controller device comprising:
a memory storing computer-executable instructions; and
a processor to execute the computer-executable instructions to at least:
set a first timing parameter of a first therapy signal, wherein the first therapy signal is delivered to a nerve innervating an extrinsic laryngeal muscle of a subject to promote anteriosuperior motion of a hyolaryngeal complex;
set a second timing parameter of a second therapy signal, wherein the second therapy signal is delivered to a recurrent laryngeal nerve (RLN) of the subject to promote vocal fold closure;
receive an input related to at least one of a physiological parameter detected by a sensor and a volitional input; and
adjust the first timing parameter of the first therapy signal and the second timing parameter of the second therapy signal to promote swallowing based on synergistic anteriosuperior motion of the hyolaryngeal complex and the vocal fold closure to prevent or mitigate aspiration in the subject during a swallow cycle based on the input.
9. The controller of claim 8 , wherein the processor further executes the computer-executable instructions to adjust a strength parameter of the first therapy signal or the second therapy signal based on a change in a sensed physiological parameter.
10. The controller of claim 8 , wherein the controller is configured to be coupled to at least one sensor to sense the change in the physiological parameter.
11. The controller of claim 10 , wherein the sensor is selected from the group consisting of a submental EMG sensor, a palatal tongue pressure sensor, a hypopharyngeal pressure sensor, an inner ear pressure sensor, a nasalis EMG sensor, a superior laryngeal nerve activity sensor, a submandibular nerve activity sensor, a lingual nerve activity sensor, a glossopharyngeal nerve activity sensor, and a soft palate EMG sensor.
12. The controller of claim 8 , wherein the first timing parameter of the first therapy signal and the second timing parameter of the second therapy signal are adjusted to treat an upper airway disorder.
13. The controller of claim 12 , wherein the upper airway disorder is at least one of a swallow cycle disorder of the subject, a laryngeal disorder of the subject, and a laryngospasm of the subject.