{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:11:45Z","timestamp":1783433505000,"version":"3.54.6"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,7,10]],"date-time":"2013-07-10T00:00:00Z","timestamp":1373414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Injury to the external branch of the superior laryngeal nerve (EBSLN) can occur during superior pole dissection in thyroid surgery; the EBSLN injury rate is reported as high as 28 % (Cernea et al., Head Neck 14:380\u2013383, 1992). Injury to the EBSLN leads to variable symptoms that may be overlooked, but that can be significant, especially to professional speakers and singers. Intraoperative nerve monitoring (IONM) is employed widely to aid in nerve identification. We report on normative electroneuromyography (EMG) data on EBSLN\u2010IONM and cricothyroid muscle (CTM) twitch response during stimulation as an aid to EBSLN identification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study of the SLN and the recurrent laryngeal nerve (RLN) IONM data in 72 consecutive thyroid surgeries was carried out. All patients underwent preoperative and postoperative laryngeal exams, and patients with abnormal preoperative laryngeal function were excluded. Normative EMG data and CTM twitch response during EBSLN stimulation were recorded and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Stimulation of the EBSLN resulted in a positive CTM twitch response in 100 %, whereas EMG response was recordable in 80 %. Electromyographic amplitude was ~1\/3 of ipsilateral RLN amplitude and did not change through the case with multiple stimulations. Stimulation of the EBSLN was similar for men and women and at 1 and 2\u00a0mA stimulation levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intraoperative nerve monitoring of the EBSLN aids in EBSLN identification and provides electroneuromyographic information in 80 % of cases. The laryngeal head of the sternothyroid muscle is a useful landmark to locate EBSLN.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2148-9","type":"journal-article","created":{"date-parts":[[2013,7,9]],"date-time":"2013-07-09T18:44:01Z","timestamp":1373395441000},"page":"2336-2342","source":"Crossref","is-referenced-by-count":58,"title":["Normative Intra\u2010operative Electrophysiologic Waveform Analysis of Superior Laryngeal Nerve External Branch and Recurrent Laryngeal Nerve in Patients Undergoing Thyroid Surgery"],"prefix":"10.1002","volume":"37","author":[{"given":"Andre S.","family":"Potenza","sequence":"first","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otology and Laryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School 243 Charles Street 02114 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eimear A.","family":"Phelan","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otology and Laryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School 243 Charles Street 02114 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio R.","family":"Cernea","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian M.","family":"Slough","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otology and Laryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School 243 Charles Street 02114 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipti V.","family":"Kamani","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otology and Laryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School 243 Charles Street 02114 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlie","family":"Darr","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otology and Laryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School 243 Charles Street 02114 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zurakowski","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Surgery Children\u2019s Hospital, Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Randolph","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otology and Laryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School 243 Charles Street 02114 Boston MA USA"},{"name":"Division of Surgical Oncology, Endocrine 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