Monitoring of the posterior cricoarytenoid muscle represents another option for neural monitoring during thyroid surgery: Normative vagal and recurrent laryngeal nerve posterior cricoarytenoid muscle electromyographic data

Intraoperative neural monitoring (IONM) of laryngeal nerves using electromyography (EMG) is routinely performed using endotracheal tube surface electrodes adjacent to the vocalis muscles. Other laryngeal muscles such as the posterior cricoarytenoid muscle (PCA) are indirectly monitored. The PCA may be directly and reliably monitored through an electrode placed in the postcricoid region. Herein, we describe the method and normative data for IONM using PCA EMG.

[1]  Samuel R. Barber,et al.  The electrophysiology of thyroid surgery: electrophysiologic and muscular responses with stimulation of the vagus nerve, recurrent laryngeal nerve, and external branch of the superior laryngeal nerve , 2017, The Laryngoscope.

[2]  G. Randolph,et al.  Intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve during thyroid and parathyroid surgery: Experience with 1,381 nerves at risk , 2017, The Laryngoscope.

[3]  K. Lorenz,et al.  Posterior cricoarytenoid muscle electrophysiologic changes are predictive of vocal cord paralysis with recurrent laryngeal nerve compressive injury in a canine model , 2016, The Laryngoscope.

[4]  N. Aygun,et al.  Motor function of the recurrent laryngeal nerve: Sometimes motor fibers are also located in the posterior branch. , 2016, Surgery.

[5]  H. Dralle,et al.  IONM of the Recurrent Laryngeal Nerve , 2016 .

[6]  G. Randolph The Recurrent and Superior Laryngeal Nerves , 2016 .

[7]  M. Barczyński,et al.  The Overwhelming Majority but not All Motor Fibers of the Bifid Recurrent Laryngeal Nerve are Located in the Anterior Extralaryngeal Branch , 2015, World Journal of Surgery.

[8]  G. Randolph,et al.  The vagus nerve, recurrent laryngeal nerve, and external branch of the superior laryngeal nerve have unique latencies allowing for intraoperative documentation of intact neural function during thyroid surgery , 2015, The Laryngoscope.

[9]  P. Friedlander,et al.  Gender, race, and electrophysiologic characteristics of the branched recurrent laryngeal nerve , 2014, The Laryngoscope.

[10]  A. Miyauchi,et al.  External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement , 2013, The Laryngoscope.

[11]  D. Zurakowski,et al.  Normative Intra-operative Electrophysiologic Waveform Analysis of Superior Laryngeal Nerve External Branch and Recurrent Laryngeal Nerve in Patients Undergoing Thyroid Surgery , 2013, World Journal of Surgery.

[12]  Paul Friedlander,et al.  Motor and sensory branching of the recurrent laryngeal nerve in thyroid surgery. , 2011, Surgery.

[13]  D. Slakey,et al.  Recurrent laryngeal nerve: significance of the anterior extralaryngeal branch. , 2011, Surgery.

[14]  T. Sloan,et al.  Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: International standards guideline statement , 2011, The Laryngoscope.

[15]  Ka-Wo Lee,et al.  Surgical anatomy and neurophysiology of the vagus nerve (VN) for standardised intraoperative neuromonitoring (IONM) of the inferior laryngeal nerve (ILN) during thyroidectomy , 2010, Langenbeck's Archives of Surgery.

[16]  C. Sekulla,et al.  What are normal quantitative parameters of intraoperative neuromonitoring (IONM) in thyroid surgery? , 2010, Langenbeck's Archives of Surgery.

[17]  T. Fahey Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy , 2010 .

[18]  J. Serpell,et al.  The Motor Fibers of the Recurrent Laryngeal Nerve Are Located in the Anterior Extralaryngeal Branch , 2009, Annals of surgery.

[19]  R. Sataloff,et al.  The innervation of the posterior cricoarytenoid muscle: exploring clinical possibilities. , 2009, Journal of voice : official journal of the Voice Foundation.

[20]  A. Sitges-Serra,et al.  Risk factors for transient vocal cord palsy after thyroidectomy , 2008, The British journal of surgery.

[21]  J. Kobler,et al.  Recurrent Laryngeal Nerve Identification and Assessment during Thyroid Surgery: Laryngeal Palpation , 2004, World Journal of Surgery.

[22]  X. León,et al.  Variability of the Nerve Supply Patterns of the Human Posterior Cricoarytenoid Muscle , 2003, The Laryngoscope.

[23]  C. Bradford,et al.  Recurrent Laryngeal Nerve Monitoring in Thyroid and Parathyroid Surgery: The University of Michigan Experience , 2003, The Laryngoscope.

[24]  R. Otto,et al.  Sensitivity and Specificity of Intraoperative Recurrent Laryngeal Nerve Stimulation in Predicting Postoperative Nerve Paralysis , 2002, The Annals of otology, rhinology, and laryngology.

[25]  Anjum S Khan,et al.  Clinical evoked electromyography for recurrent laryngeal nerve preservation: Use of an endotracheal tube electrode and a postcricoid surface electrode , 1998, The Laryngoscope.

[26]  A. Khan,et al.  Experience with two types of electromyography monitoring electrodes during thyroid surgery. , 1997, American journal of otolaryngology.

[27]  Anjum Khan,et al.  Recurrent laryngeal nerve location in thyroidectomy and parathyroidectomy: Use of an indwelling laryngeal surface electrode with evoked electromyography , 1994 .

[28]  Rea Jl Postcricoid surface laryngeal electrode , 1992 .

[29]  J. L. Rea Postcricoid surface laryngeal electrode. , 1992, Ear, nose, & throat journal.

[30]  T. Higenbottam,et al.  A new method for laryngeal electromyography. , 1981, Clinical otolaryngology and allied sciences.