{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:22:30Z","timestamp":1792678950263,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,4,26]],"date-time":"2016-04-26T00:00:00Z","timestamp":1461628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Injury to the recurrent laryngeal nerve (RLN) is a dreaded complication of endocrine surgery. Intraoperative neural monitoring (IONM) has been increasingly utilized to assess the functional status of the RLN. Although the posterior cricoarytenoid muscle (PCA) is innervated by the RLN as the abductor of the larynx, PCA electromyography (EMG) is infrequently recorded during IONM and PCA activity after RLN compressive injury remains poorly characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Single\u2010subject prospective animal study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We employed a canine model to identify postcricoid EMG correlates of postoperative vocal cord paralysis (VCP). Postcricoid electrode recordings were obtained before and after compressive RLN injury associated with VCP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Normative postcricoid recordings revealed mean amplitude of 1288 microvolt (\u03bcV) and latency of 8.2 millisecond (ms) with maximum (1 milliamp [mA]) vagal stimulation, and mean amplitude of 1807 \u03bcV and latency of 3.5 ms with maximum (1 mA) RLN stimulation. Following injury that was associated with VCP, there was 62.1% decrement in postcricoid EMG amplitude with maximum vagal stimulation and 80% decrement with maximum RLN stimulation. Threshold stimulation of the vagus increased by 23%, and there was a corresponding 42% decrease in amplitude. For RLN stimulation, latency increased by 17.3% following injury, whereas threshold stimulation increased by 61% with 35.5% decrement in EMG amplitude. Thus, if RLN amplitude decreases by \u2265 80%, with absolute amplitude of \u2264 300 \u03bcV or less and latency increase of \u2265 10%, RLN injury is likely associated with VCP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results predict postoperative VCP based on postcricoid electromyographic IONM and may guide surgical decision making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 126:2744\u20132751, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25967","type":"journal-article","created":{"date-parts":[[2016,4,27]],"date-time":"2016-04-27T02:28:27Z","timestamp":1461724107000},"page":"2744-2751","source":"Crossref","is-referenced-by-count":18,"title":["Posterior cricoarytenoid muscle electrophysiologic changes are predictive of vocal cord paralysis with recurrent laryngeal nerve compressive injury in a canine model"],"prefix":"10.1002","volume":"126","author":[{"given":"Sidharth V.","family":"Puram","sequence":"first","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery Department of Otolaryngology Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold","family":"Chow","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery Department of Otolaryngology Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Che\u2010Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery Department of Otolaryngology Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Kaohsiung Medical University Hospital; Faculty of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T.","family":"Heaton","sequence":"additional","affiliation":[{"name":"Department of Surgery Massachusetts General Hospital and Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipti","family":"Kamani","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery Department of Otolaryngology Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautham","family":"Gorti","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery Department of Otolaryngology Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng Yu","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Kaohsiung Medical University Hospital; Faculty of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianlorenzo","family":"Dionigi","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Human Morphology Division of Surgery University of Insubria\u2013School of Medicine Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Barczynski","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Jagiellonian University Medical College Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of General Visceral, and Vascular Surgery, Martin Luther University Halle\u2010Wittenberg Halle (Saale) Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Dralle","sequence":"additional","affiliation":[{"name":"Department of General Visceral, and Vascular Surgery, Martin Luther University Halle\u2010Wittenberg Halle (Saale) Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Department of General Visceral, and Vascular Surgery, Martin Luther University Halle\u2010Wittenberg Halle (Saale) Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Randolph","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery Department of Otolaryngology Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Division of Surgical Oncology Department of Surgery Massachusetts General Hospital and Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2008.01875.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.9.1131"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199809000-00032"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(97)90095-8"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200302000-00028"},{"key":"e_1_2_6_7_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1177\/014556139207100604","article-title":"Postcricoid surface laryngeal electrode","volume":"71","author":"Rea JL","year":"1992","journal-title":"Ear Nose Throat 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