scholarly journals Terminal Branch of Recurrent Human Laryngeal Nerve

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Andréa Aparecida Ferreira Pascoal ◽  
Juliana Ruiz Fernandes ◽  
Cristiane Regina Ruiz ◽  
Osmar Clayton Person ◽  
Sergio Ricardo Rios Nascimento
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Cricoid Cartilage ◽  
Superior Laryngeal Nerve ◽  
Variable Number ◽  
Laryngeal Nerve ◽  
Terminal Branch ◽  
Lower Margin ◽  
Internal Branch ◽  
Posterior Cricoarytenoid Muscle ◽  
Posterior Cricoarytenoid

The importance of the recurrent laryngeal nerve in surgery on the anterior region of the neck has motivated many published papers on critical points of its pathway, relationship with the inferior thyroid artery, penetration in the larynx, division outside the larynx, and branches communicating with the internal branch of the superior laryngeal nerve. We analyze the terminal branches of the recurrent laryngeal nerve and their distribution through the laryngeal muscles. 44 laryngeal nerves had been dissected. Most frequently, the recurrent laryngeal nerve presents a division below or at the level of the lower margin of the cricoid cartilage (outside the larynx). One of these branches forms the communication with the internal branch of the superior laryngeal nerve, and the other penetrates the laryngeal space. Above the lower margin of the cricoid cartilage, the inferior laryngeal nerve issues a variable number of branches to muscles (3 to 7): to the posterior cricoarytenoid muscle; to the oblique and transversal arytenoid muscles; and to the lateral cricoarytenoid muscle and the thyroarytenoid muscle.

Arrangement and number of intralaryngeal ganglia and ganglionic neurons: comparative study of five species of mammals

1995 ◽  
Vol 109 (7) ◽  
pp. 622-629 ◽  
Author(s):  
Takatsugu Shimazaki ◽  
Yoshikazu Yoshida ◽  
Minoru Hirano
Keyword(s):  
Connective Tissue ◽  
Guinea Pig ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
The Other ◽  
Inferior Laryngeal Nerve ◽  
Internal Branch ◽  
Posterior Cricoarytenoid Muscle ◽  
Round Nucleus ◽  
Posterior Cricoarytenoid

AbstractThe arrangement and number of intralaryngeal ganglia and their neurons in five mammals (dog, rat, guinea pig, rabbit and cat) were examined morphologically. Intralaryngeal ganglions were situated mainly in branches of the internal branch of superior laryngeal nerve (Int-SLN), dorsal and/or dorsolateral to the posterior cricoarytenoid muscle, and around the inferior laryngeal nerve in dogs, rats, guinea pigs and cats, but they were identified at the branching out point ofthe Int-SLN exclusively in rabbits. The ganglion of each animal was spindle-shaped, with a surrounding fibrous capsule, and it contained many ganglionic neurons, vessels and connective tissue cells. The ganglionic neuron was oval-shaped and had a round nucleus: the diameter was smaller (20–25 μm) in the rat than in the other mammals (25–30 μm). More than 80 percent of ganglionic neurons occurred in the supraglottis of all the animals except the rat. In the rat, this value was approximately 40 percent.

Effects of Recurrent Laryngeal Nerve Transection and Vagotomy on Respiratory Contraction of the Cricothyroid Muscle

1989 ◽  
Vol 98 (5) ◽  
pp. 373-378 ◽  
Author(s):  
Gayle E. Woodson
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Superior Laryngeal Nerve ◽  
Upper Airway ◽  
Vocal Folds ◽  
Laryngeal Nerve ◽  
Electromyographic Activity ◽  
Airway Occlusion ◽  
Cricothyroid Muscle ◽  
Bilateral Vagotomy ◽  
Posterior Cricoarytenoid

The cricothyroid muscle (CT) appears to be an accessory muscle of respiration. Phasic inspiratory contraction is stimulated by increasing respiratory demand. Reflex activation of the CT may be responsible for the paramedian position of the vocal folds, and hence airway obstruction, in patients with bilateral recurrent laryngeal nerve (RLN) paralysis. Previous research has demonstrated the influence of superior laryngeal nerve (SLN) afferents on CT activity. The present study addresses the effects of vagal and RLN afferents. Electromyographic activity of the CT and right posterior cricoarytenoid muscle was monitored in anesthetized cats during tracheotomy breathing and in response to tracheal or upper airway occlusion in the intact animal. This was repeated following left RLN transection, bilateral vagotomy, and bilateral SLN transection. Vagotomy abolished CT response to tracheal occlusion and markedly reduced the response to upper airway occlusion. Vocal fold position following RLN transection appeared to correlate with CT activity; however, observed changes were minor.

Surgical Anatomy of the Recurrent Laryngeal Nerve: Implications for Laryngeal Reinnervation

2003 ◽  
Vol 112 (5) ◽  
pp. 434-438 ◽  
Author(s):  
Edward J. Damrose ◽  
Robert Y. Huang ◽  
Gerald S. Berke ◽  
Ming Ye ◽  
Joel A. Sercarz
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Adductor Muscle ◽  
Surgical Anatomy ◽  
Laryngeal Nerve ◽  
Main Trunk ◽  
Posterior Cricoarytenoid Muscle ◽  
Laryngeal Reinnervation ◽  
Human Cadavers ◽  
Muscle Groups ◽  
Posterior Cricoarytenoid

Functional laryngeal reinnervation depends upon the precise reinnervation of the laryngeal abductor and adductor muscle groups. While simple end-to-end anastomosis of the recurrent laryngeal nerve (RLN) main trunk results in synkinesis, functional reinnervation can be achieved by selective anastomosis of the abductor and adductor RLN divisions. Few previous studies have examined the intralaryngeal anatomy of the RLN to ascertain the characteristics that may lend themselves to laryngeal reinnervation. Ten human larynges without known laryngeal disorders were obtained from human cadavers for RLN microdissection. The bilateral intralaryngeal RLN branching patterns were determined, and the diameters and lengths of the abductor and adductor divisions were measured. The mean diameters of the abductor and adductor divisions were 0.8 and 0.7 mm, while their mean lengths were 5.7 and 6.1 mm, respectively. The abductor division usually consisted of one branch to the posterior cricoarytenoid muscle; however, in cases in which multiple branches were seen, at least one dominant branch could usually be identified. We conclude that the abductor and adductor divisions of the human RLN can be readily identified by an extralaryngeal approach. Several key landmarks aid in the identification of the branches to individual muscles. These data also indicate the feasibility of selective laryngeal reinnervation in patients who might be candidates for laryngeal transplantation after total laryngectomy.

Function of the Posterior Cricoarytenoid Muscle in Phonation: In vivo Laryngeal Model

1993 ◽  
Vol 109 (6) ◽  
pp. 1043-1051 ◽  
Author(s):  
Hong-Shik Choi ◽  
Gerald S. Berke ◽  
Ming Ye ◽  
Jody Kreiman
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Fundamental Frequency ◽  
Nerve Stimulation ◽  
Sound Intensity ◽  
Vocal Folds ◽  
Laryngeal Nerve ◽  
Posterior Cricoarytenoid Muscle ◽  
Posterior Cricoarytenoid ◽  
Stimulation Of

The function of the posterior cricoarytenoid (PCA) muscle in phonation has not been well documented. To date, several electromyographic studies have suggested that the PCA muscle is not simply an abductor of the vocal folds, but also functions in phonation. This study used an in vivo canine laryngeal model to study the function of the PCA muscle. Subglottic pressure and electroglottographic, photogiottographic, and acoustic waveforms were gathered from five adult mongrel dogs under varying conditions of nerve stimulation. Subglottic pressure, fundamental frequency, sound intensity, and vocal efficiency decreased with increasing stimulation of the posterior branch of the recurrent laryngeal nerve. These results suggest that the PCA muscle not only acts to brace the larynx against the anterior pull of the adductor and cricothyroid muscles, but also functions inhibitorily in phonation by controlling the phonatory glottal width.

Thyroid cartilage movements during breathing

1995 ◽  
Vol 78 (2) ◽  
pp. 441-448 ◽  
Author(s):  
T. C. Amis ◽  
A. Brancatisano ◽  
A. Tully
Keyword(s):  
Electrical Stimulation ◽  
Recurrent Laryngeal Nerve ◽  
Thyroid Cartilage ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Electromyographic Activity ◽  
Tidal Breathing ◽  
Left And Right ◽  
Posterior Cricoarytenoid ◽  
Stimulation Of

We measured lateral (outward) thyroid cartilage displacement (TCD) of the larynx in six supine anesthetized (intravenous chloralose) dogs. Combined left and right TCDs were measured with linear transducers attached by a thread to the thyroid alae. During tidal breathing via a tracheostomy, phasic inspiratory TCD occurred in all dogs [0.66 +/- 0.2 mm (mean +/- SE)] together with phasic inspiratory electromyographic activity in the cricothyroid (CT) and posterior cricoarytenoid (PCA) muscles. During brief tracheal occlusions, TCD increased significantly to 1.27 +/- 0.2 mm (P = 0.001), accompanied by an increase of 95–115% in the peak CT and PCA electromyograms. Bilateral supramaximal electrical stimulation of the external branches of the superior laryngeal nerve (ExSLN) produced a TCD of 9.9 +/- 0.8 mm; however, similar stimulation of the recurrent laryngeal nerve (RLN) produced a TCD of only 1.33 +/- 0.1 mm (P = 0.0001). Furthermore, bilateral section of the ExSLN in five dogs significantly reduced tidal TCD by 48.7 +/- 24.4% (P < 0.05), and bilateral section of both the ExSLN and RLN resulted in slight phasic inward TCD (-0.06 +/- 0.05 mm). Thus, it appears that the activities of both the CT and RLN-innervated muscles (probably the PCA muscle) contribute to tidal breathing TCD. These findings suggest that inspiratory dilation of the hypopharynx is mediated by contractions of CT and PCA muscles.

Evoked Electromyographic Technique for Quantitative Assessment of the Innervation Status of Laryngeal Muscles

2005 ◽  
Vol 114 (7) ◽  
pp. 563-572 ◽  
Author(s):  
David L. Zealear ◽  
Matthew R. Swelstad ◽  
Scott Fortune ◽  
Ricardo J. Rodriguez ◽  
Sung-Min Chung ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Quantitative Information ◽  
Laryngeal Nerve ◽  
Noninvasive Technique ◽  
Laryngeal Muscles ◽  
Phase Study ◽  
Posterior Cricoarytenoid Muscle ◽  
Muscle Innervation ◽  
Posterior Cricoarytenoid ◽  
Thyroarytenoid Muscle

Objectives: The purpose of this study was to develop a minimally invasive, noninjurious evoked electromyographic technique that could accurately quantitate the level of innervation of laryngeal muscles with recurrent laryngeal nerve stimulation. Methods: A four-phase study was conducted in 24 canines, including 1) identification of the best stimulation-recording configuration, 2) statistical analysis of sensitivity and accuracy, 3) evaluation of safety, and 4) identification of the laryngeal muscle(s) that contribute to the evoked response. Results: The results demonstrated that an entirely noninvasive technique is not feasible. The stimulating cathode must be invasive to ensure discrete activation of the recurrent laryngeal nerve, whereas both recording electrodes should remain on the surface with one overlying the thyroid ala. This configuration proved to be highly accurate, with an error rate of only 6% to 7%, and with sensitivity sufficient to detect a signal in a nerve with fewer than 1% of the axons intact. There was no evidence of nerve injury in any animal over the course of 350 stimulus needle penetrations. By use of neuromuscular blockade to identify those muscles generating the surface response, the thyroarytenoid muscle was found to be the primary contributor, whereas the posterior cricoarytenoid muscle was uninvolved. Conclusions: This evoked electromyographic technique could provide quantitative information regarding the extent of muscle innervation during denervation and regeneration in case of laryngeal paralysis.

Innervation of the human posterior cricoarytenoid muscle by the external branch of the superior laryngeal nerve

Head & Neck ◽  
2017 ◽  
Vol 39 (11) ◽  
pp. 2200-2207 ◽  
Author(s):  
Mehmet Uludag ◽  
Nurcihan Aygun ◽  
Kinyas Kartal ◽  
Evren Besler ◽  
Adnan Isgor
Keyword(s):  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
External Branch ◽  
Posterior Cricoarytenoid Muscle ◽  
Posterior Cricoarytenoid

Influence of lung volume on activities of branches of the recurrent laryngeal nerve

1989 ◽  
Vol 67 (3) ◽  
pp. 1179-1184 ◽  
Author(s):  
Q. Huang ◽  
D. Zhou ◽  
W. M. St John ◽  
D. Bartlett
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Phrenic Nerve ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Vagal Afferents ◽  
Lung Inflation ◽  
Neural Activities ◽  
Motor Nerves ◽  
Posterior Cricoarytenoid ◽  
End Tidal

To investigate the influence of inspiratory lung inflation on the respiratory activities of laryngeal motor nerves, vagally intact decerebrate paralyzed cats were ventilated by a servorespirator in accordance with their own phrenic nerve activity. Records were made of the activities of the phrenic nerve, the superior laryngeal nerve (SLN), the recurrent laryngeal nerve (RLN), and the intralaryngeal branches of the RLN serving the thyroarytenoid (TA) and posterior cricoarytenoid (PCA) muscles. Neural activities were assessed in the steady state at different end-tidal O2 and CO2 concentrations. Transient responses to withholding inspiratory lung inflation and to preventing expiratory lung emptying were also studied. Hypercapnia and hypoxia increased the inspiratory activities of the phrenic nerve, SLN, RLN, and its PCA branch. TA inspiratory activity was not changed. Expiratory activities of RLN, PCA, and TA were all increased in hypoxia. When lung inflation was withheld, neural inspiratory duration and the inspiratory activities of all nerves increased. The subsequent period of neural expiration was marked by an exaggerated burst of activity by the TA branch of the RLN. TA expiratory activity was also sharply increased after inspiratory efforts that were reflexly delayed by the prevention of lung emptying. TA activity in expiration was enhanced after vagotomy and was usually more prominent than when lung inflation was withheld before vagal section. The results demonstrate the importance and complexity of the influence of vagal afferents on laryngeal motor activity.

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