Neuromuscular electrical stimulation of the cricothyroid muscle in patients with suspected superior laryngeal nerve weakness

J Voice. 2014 Mar;28(2):216-25. doi: 10.1016/j.jvoice.2013.09.003. Epub 2013 Dec 4.


In this retrospective case study, we report the apparent clinical effectiveness of neuromuscular electrical stimulation (NMES) in combination with voice therapy (VT) for rehabilitating dysphonia secondary to suspected superior laryngeal nerve (SLN) weakness in two female patients. Both patients failed or plateaued with traditional VT but had significant improvement with the addition of NMES of the cricothyroid muscle and SLN using a VitalStim unit. Stimulation was provided simultaneously with voice exercises based on musical phonatory tasks. Both acoustic analysis and endoscopic evaluation demonstrated important improvements after treatment. In the first patient, the major change was obtained within the primo passaggio region; specifically, a decrease in voice breaks was demonstrated. In the second patient, an improvement in voice quality (less breathiness) and vocal range were the most important findings. Additionally, each patient reported a significant improvement in their voice complaints. Neuromuscular laryngeal electrical stimulation in combination with vocal exercises might be a useful tool to improve voice quality in patients with SLN injury.

Keywords: Cricothyroid muscle; Neuromuscular electrical stimulation; Superior laryngeal nerve; Surface electrical stimulation; Vocal folds paresis; Voice therapy.

Publication types

  • Case Reports

MeSH terms

  • Acoustics
  • Combined Modality Therapy
  • Electric Stimulation Therapy / instrumentation*
  • Female
  • Humans
  • Laryngeal Muscles / innervation*
  • Laryngeal Nerves / physiopathology*
  • Middle Aged
  • Neural Prostheses*
  • Phonation*
  • Recovery of Function
  • Retrospective Studies
  • Singing*
  • Sound Spectrography
  • Time Factors
  • Treatment Outcome
  • Vocal Cord Paralysis / diagnosis
  • Vocal Cord Paralysis / physiopathology
  • Vocal Cord Paralysis / therapy*
  • Voice Quality*
  • Voice Training*