Electrical Stimulation in Treatment of Pharyngolaryngeal Dysfunctions

Abstract

Objective: Neuromuscular electrical stimulation (NMES) has been proposed in the treatment of laryngopharyngeal dysfunctions (dysphonia, dyspnoea, dysphagia) for more than 40 years. Several studies have investigated possible therapeutic effects. Some researchers described favourable results, whereas others did not find relevant benefits. This article aims to review available studies to give an overview regarding the current state of knowledge. Methods: We conducted a selective literature search using PubMed. Results: In total, 356 papers were identified: 6 case reports, 11 reviews, 43 prospective clinical trials and 3 retrospective trials were found. Conclusion: Due to different stimulation protocols, electrode positioning and various underlying pathological conditions, summarizing the present studies appears to be difficult. However, there is evidence that NMES is a valuable adjunct in patients with dysphagia and in patients with vocal fold paresis. Nevertheless, more empirical data is needed to fully understand the benefits provided by NMES. Further research suggestions are put forward.

Preliminary outcomes in transcutaneous neuromuscular electrical stimulation use in patients with dysphagia

“…Some studies sustain the positive effect of the swallowing rehabilitation by using NMES 10,13,20,[28][29][30][31][32] . Ludlow et al 28 , in a study conducted in 2007 on 11 patients with pharyngeal dysphagia of different etiologies, reported a decrease in aspiration phenomena and penetration after electrical stimulation, by measuring with videofluoroscopy the hyoid movement and the subglottic air column position.…”

“…There are also many studies presenting a negative effect of neuromuscular electrical stimulation or no significant difference between electrical stimulation therapy and traditional dysphagia treatment 13,[33][34][35][36][37] . Studying the effect of surface electrical stimulation in normal volunteers, with the placement of different electrodes, Humbert et al 33 concluded that surface stimulation "would not be an acceptable alternative to the more invasive intramuscular stimulation for enhancing the hyolaryngeal elevation in dysphagia".…”

“…The primary goal of dysphagia treatment is to improve the swallowing process and decrease the risk of aspiration. Each treatment protocol for swallowing disorders has three important components: restitution, compensation, adaptation 13 . Restitution implies the total or partial recovery of swallowing and it consists in thermal and/or tactile stimulation, mobilization and movement exercises (for the lips, the tongue and the larynx).…”

Neuromuscular Electrical Stimulation for Treatment-Refractory Chronic Dysphagia in Tube-Fed Patients: A Prospective Case Series

“…The efficacy of NMES on dysphagia is still a matter of debate. In a recent structured review of the literature, Miller et al [8] reported that NMES could be a valid adjunct in patients with dysphagia and in patients with vocal fold paresis and underlined the need for more empirical data in order to fully understand the benefit of NMES. Some authors, in fact, documented swallowing improvement after NMES treatment, while other studies reported no effect of NMES on swallowing ability [1].…”

Eficácia da eletroestimulação neuromuscular no tratamento da disfagia orofaríngea em idosos acometidos por acidente vascular encefálico

“…Alguns estudos têm demonstrado melhora na fisiologia da deglutição (FREED et al, 2001;BLUMENFELD et al, 2006;BOGAARDT et al, 2009) GALLAS et al, 2010;HUANG et al, 2010;XIA et al, 2011 MEARIN, 2009;FALSETTI et al, 2009;DANIELS et al, 2009;BINGJIE et al, 2010;PARK et al, 2010 Em uma revisão de literatura, Miller et al (2013) tiveram como objetivo revisar os benefícios da EENM no tratamento da disfonia, dispnéia e da disfagia para demonstrar uma visão geral do atual estado de conhecimento nesta área. (SOUZA et al, 2003).…”