Cricothyroid muscle paralysis: its recognition and diagnosis

Bevan, K.; Griffiths, M. V.; Morgan, M.

doi:10.1017/s0022215100108412

Cited by 48 publications

(42 citation statements)

References 13 publications

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“…The authors also described that the aryepiglottic fold is shortened on the side of the paralysis (58). There may be bowing and high mismatch with inferior displacement of the vocal cord on the affected side (31,52,54,59), as well as vocal fold hypomobility, mucosal asymmetrical waveform excursion and phase asymmetry (31,54).…”

Section: Ebsln Function and Dysfunctionmentioning

confidence: 98%

“…Mild changes to the speaking voice have been described, as the singing voice is more severely affected. Symptoms are described among several authors as a voice that is weak, breathy, monotonous and characterized by compression on the pitch range with inability to achieve high pitch tasks (52)(53)(54)(55). Patients may complain of weakness, tightness, and increased effort to speak (52,55).…”

Section: Ebsln Function and Dysfunctionmentioning

confidence: 99%

“…Symptoms are described among several authors as a voice that is weak, breathy, monotonous and characterized by compression on the pitch range with inability to achieve high pitch tasks (52)(53)(54)(55). Patients may complain of weakness, tightness, and increased effort to speak (52,55). Aerodynamic measures have shown increased subglottic pressures and decreased airflow rates when the CTM is paralytic (56), as well as increased jitter (55).…”

Section: Ebsln Function and Dysfunctionmentioning

confidence: 99%

“…LEMG is the most useful and precise method to recognize EBSLN dysfunction (52,64). Nevertheless, its applicability is limited in the routine practice because it is invasive and technically difficult.…”

Section: Ebsln Function and Dysfunctionmentioning

confidence: 99%

See 3 more Smart Citations

Injury of the external branch of the superior laryngeal nerve in thyroid surgery

Potenza¹,

Filho²,

Cernea³

2017

Gland Surg.

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Section: Ebsln Function and Dysfunctionmentioning

confidence: 98%

Section: Ebsln Function and Dysfunctionmentioning

confidence: 99%

Section: Ebsln Function and Dysfunctionmentioning

confidence: 99%

Section: Ebsln Function and Dysfunctionmentioning

confidence: 99%

See 2 more Smart Citations

Injury of the external branch of the superior laryngeal nerve in thyroid surgery

Potenza¹,

Filho²,

Cernea³

2017

Gland Surg.

View full text Add to dashboard Cite

“…SLNP is then verified using EMG and clinical acoustic measurements (Sulica, 2004). Although laryngeal EMG is the definitive tool (Bevan et al, 1989; Xu et al, 2007) to diagnose SLNP, visual, acoustic, and aerodynamic diagnosis is less time consuming, less invasive, less expensive, and happens earlier in the course of patient contact. Refinement of visual, acoustic, and aerodynamic diagnostic techniques could supplant the use of EMG in the future.…”

Section: Introductionmentioning

confidence: 99%

Aerodynamic and Nonlinear Dynamic Acoustic Analysis of Tension Asymmetry in Excised Canine Larynges

Devine

Bulleit

Hoffman

et al. 2012

J Speech Lang Hear Res

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Objective/hypothesis To model tension asymmetry caused by superior laryngeal nerve paralysis (SLNP) in excised larynges and apply perturbation, nonlinear dynamic, and aerodynamic analyses. Methods SLNP was modeled in 8 excised larynges using sutures and weights to mimic cricothyroid (CT) muscle function. Weights were removed from one side to create tension asymmetry, mimicking unilateral SLNP. Two sets of weights were used, one light and one heavy. Experimental measurements were made for five conditions: no tension; symmetrical light tension; asymmetrical light tension; symmetrical heavy tension; and asymmetrical heavy tension. Results Perturbation parameters were not significantly different across conditions (percent jitter: p=0.451; percent shimmer: p=0.321). Additionally, many measurements were invalid (error values > 10). Second order entropy (K2) was significantly different across conditions (p=0.002), while correlation dimension (D2) was not (p=0.428). Validity of these nonlinear dynamic parameters was demonstrated by low standard deviations. Phonation threshold pressure (p<0.001) and power (p=0.05) differed significantly across conditions, while phonation threshold flow did not (p=0.396). Conclusions Nonlinear dynamic analysis differentiated between symmetrical and asymmetrical tension conditions while traditional perturbation analysis was less useful characterizing type 2 or 3 vocal signals. Supplementing acoustic with aerodynamic parameters may help distinguish among laryngeal disorders of neuromuscular origin.

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Superior laryngeal nerve monitoring using laryngeal surface electrodes and intraoperative neurophysiological monitoring during thyroidectomy

et al. 2014

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The objective of this study is to establish normative waveform data for the external branch of the superior laryngeal nerve (SLN) utilizing laryngeal surface electrodes and intraoperative neurophysiological monitoring (IONM) in conjunction with a clinical neurophysiologist. A retrospective chart review of 91 consecutive at-risk SLN were identified in 51 patients in whom IONM using laryngeal surface electrodes was performed by a clinical neurophysiologist using Dragonfly (Neurovision Medical Products, Ventura, CA) recording electrodes and a Protektor (Natus Medical Inc., San Carlos, CA)16 channel- intraoperative nerve monitoring system. Inclusion criteria were met for 30 SLN. Data collected included preoperative diagnosis, surgical procedure, rates of nerve identification and stimulation, and waveform characteristics. Waveform analysis for 30 SLN yielded a peak latency of 4.0 ± 0.2 ms, onset latency 2.3 ± 0.1 ms, peak-to-peak amplitude of 220.4 ± 31.1 µV, onset-to-peak amplitude of 186.0 ± 25.0 µV, and stimulation current threshold of 0.55 ± 0.03 mA (data = mean ± SEM). Two patients had abnormal SLN function documented clinically on postoperative laryngoscopic examination. Laryngeal surface electrodes were successfully utilized to identify and monitor SLN function intraoperatively. IONM using laryngeal surface electrodes enables analysis of waveform morphology and latency in addition to threshold and amplitude data obtained with the traditional NIM system, potentially improving the performance of nerve monitoring during thyroid surgery.

show abstract

Cricothyroid muscle paralysis: its recognition and diagnosis

Cited by 48 publications

References 13 publications

Injury of the external branch of the superior laryngeal nerve in thyroid surgery

Injury of the external branch of the superior laryngeal nerve in thyroid surgery

Aerodynamic and Nonlinear Dynamic Acoustic Analysis of Tension Asymmetry in Excised Canine Larynges

Superior laryngeal nerve monitoring using laryngeal surface electrodes and intraoperative neurophysiological monitoring during thyroidectomy

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