Laryngeal Electromyography: Electrode Guidance Based on 3-Dimensional Magnetic Resonance Tomography Images of the Larynx

Storck, Claudio; Gehrer, Raphael; Höfer, Michael; Neumayer, Bernhard; Stollberger, Rudolf; Schumacher, Ralf; Gugatschka, Markus; Friedrich, Gerhard; Wolfensberger, Markus

doi:10.1016/j.jvoice.2010.09.002

Cited by 9 publications

(6 citation statements)

References 9 publications

(16 reference statements)

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“…In addition, we found that the amplitudes of EMG signals recorded by modified transcricothyroid method were obvious differences (1,857±1,718/2,347±2,323 μV for V1/ R1), even between the left and right sides of same patient, We speculated that it may be related to the direction of needle electrode implantation (Figure 2C,D). Storck et al (20) had studied cadaveric specimens by 3-dimensional magnetic resonance tomography, he found that when the needle was inserted from the center of inferior border of TC, if the target muscle is the thyroarytenoid muscle (TAM), the needle has to be deflected laterally by 30° and upward by 15°, and if we want to reach the lateral cricoarytenoid muscle (LCAM), the needle has to be deflected laterally by 30° and downward by less than 15°. The insertion depth is about 15 mm for the TAM and 20 mm for the LCAM.…”

Section: Discussionmentioning

confidence: 99%

Modified arytenoid muscle electrode recording method for neuromonitoring during thyroidectomy

Liang¹,

Wang²,

Han³

et al. 2019

Gland Surg.

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Background: Intraoperative neuromonitoring (IONM) is an important application for protecting recurrent laryngeal nerve (RLN) during thyroid surgery. The method for recording arytenoid muscle electromyography (EMG) signals is reported to be feasible and reliable. However, the parameters of EMG signals are not provided. This study aimed to analyze the clinical characteristics of EMG signal parameters by modifying the insertion direction of needle electrodes.Methods: A total of 92 patients who were scheduled to undergo thyroidectomy were recruited. Two paired needle electrodes were inserted in bilateral angle points between rectus cricothyroid muscle and inferior margin of thyroid cartilage (TC) intraoperatively, and then the information from the EMG signals was recorded according to four-step method (V1-R1-R2-V2). Pre-and post-operative laryngo-fiberoscopy was performed to confirm the vocal cord function.Results: A total of 122 RLNs were successfully recorded during thyroidectomy, with the mean EMG amplitude and latency were 1,857±1,718/2,347±2,323 μV and 3.89±1.12/2.26±0.05 ms for V1/R1 signals before resection, and 1,924±1,705/2,450±2,345 μV and 3.87±1.17/2.27±0.08 ms for R2/V2 signals after resection. There were no significant changes before and after resection, and a normal vocal cord movement was observed postoperatively. The amplitude of left nerves was higher than that of the right ones.Furthermore, the latency of the right vagus was shorter than the left ones, but there was no difference in the amplitude and latency between age, sex and pathological types.Conclusions: Modified arytenoid muscle EMG recording method was considered to be safe, feasible and reliable. The latency of right vagus EMG signals were shorter than the left ones, and the amplitude of EMG signals might be related to different sides.

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Section: Discussionmentioning

confidence: 99%

Modified arytenoid muscle electrode recording method for neuromonitoring during thyroidectomy

Liang¹,

Wang²,

Han³

et al. 2019

Gland Surg.

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“…With the paramedian approach, distinguishing between needle insertion into the thyroarytenoid or the lateral cricoarytenoid muscle requires the physician to look at the electromyographic response. With the midline approach, muscles can be easily distinguished, as the needle points upward for the thyroarytenoid and downward for the lateral cricoarytenoid muscle . However, the midline approach also necessitates moving the needle within the airway.…”

Section: Discussionmentioning

confidence: 99%

“…Very few studies have addressed cadaveric larynx anatomy. Storck et al . studied the electrode insertion angle and insertion depth for laryngeal muscles using magnetic resonance tomography (MRT) and 3‐dimensional imaging software.…”

Section: Discussionmentioning

confidence: 99%

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Anatomical localization of the motor entry point in the thyroarytenoid muscle

2014

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“…The maximum length of the needle electrode should be 50 mm in order to penetrate even the posterior cricoarytenoid muscle (PCA) 10 ( Figure 1). Transnasal flexible laryngoscopy is the investigation that can be done routinely before, during and after laryngeal electromyography, in order to highlight the endolarynx and the vocal cord mobility 8 .…”

Section: Equipmentmentioning

confidence: 99%

Clinical application of laryngeal electromyography – a point of view

Pasu

2017

Romanian Journal of Rhinology

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In recent years, the clinical importance of laryngeal electromyography (LEMG) has been recognized. This method of investigation proved itself to be a valuable and indispensable tool regarding voice disorder management and requires multidisciplinary approach. In this article, we focus on the clinical usefulness of LEMG to assess inferior and superior motor neuron integrity by recording action potentials generated by muscle fibers of the larynx in the new field known as neurolaryngology. To facilitate the clinical application of this electrophysiologic test, we present a detailed description of LEMG techniques, which were applied for simultaneous bilateral recordings of the thyroarytenoid, cricothyroid and posterior cricoarytenoid muscles. Also, we analysed and measured the following electrophysiological parameters: 1) insertional activity; 2) spontaneous activity; 3) recruitment; 4) morphology of waveform. From a practical point of view, in our country, LEMG performance is still not a routine procedure in ENT and Phoniatric Departments. The difficulty of practical use of LEMG in Romania consists in technical limitations and it depends on the physician’s experience regarding the examination technique and also the interpretation of electrophysiological results. Our current clinical experience shows that the use of LEMG contributes especially to the diagnosis, prognosis and treatment of patients with neurolaryngological disorders.

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Laryngeal Electromyography: Electrode Guidance Based on 3-Dimensional Magnetic Resonance Tomography Images of the Larynx

Cited by 9 publications

References 9 publications

Modified arytenoid muscle electrode recording method for neuromonitoring during thyroidectomy

Modified arytenoid muscle electrode recording method for neuromonitoring during thyroidectomy

Anatomical localization of the motor entry point in the thyroarytenoid muscle

Clinical application of laryngeal electromyography – a point of view

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