title: Localization of the cricothyroid muscle under ultrasound guidance for vagal nerve mapping.
abstract: During surgical removal of tumors of the skull base or cerebellopontine angle with brainstem compression, the vagus nerve is at a high risk for injury that can result in permanent or transient swallowing and speech dysfunction. Intramuscular recording of cricothyroid muscle can be used for vagal nerve mapping during intraoperative neurophysiologic monitoring so as to prevent the above complications. However, it is a small muscle that lies beneath the strap muscles over the anterior neck and is not easily accessible by a blind approach. Here, we present a case in which cricothyroid muscle was identified for precise electrode placement under ultrasound guidance during preparation for intraoperative monitoring. We concluded that localization of the cricothyroid muscle by ultrasonography proved to be a feasible and easy technique, and the compound muscle action potential recorded by this approach is clearly recognizable during intraoperative vagal nerve mapping.
authors: Department of Physical Medicine & Rehabilitation, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei 11217, Taiwan. Electronic address: tfyang@vghtpe.gov.tw.
authors: Tsui-Fen
authors: TF
authors: Yang
authors: Department of Physical Medicine & Rehabilitation, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
authors: Jia-Chi
authors: JC
authors: Wang
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
authors: Sanford P C
authors: SP
authors: Hsu
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
authors: Cheng-Chia
authors: CC
authors: Lee
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
authors: Chun-Fu
authors: CF
authors: Lin
authors: Department of Physical Medicine & Rehabilitation, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
authors: Jan-Wei
authors: JW
authors: Chiu
authors: Department of Physical Medicine & Rehabilitation, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
authors: Chih-Jou
authors: CJ
authors: Lai
authors: Department of Physical Medicine & Rehabilitation, Taipei Veterans General Hospital, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
authors: Rai-Chi
authors: RC
authors: Chan
authors: Department of Internal Medicine, Cheng Hsin General Hospital, Taipei, Taiwan.
authors: Shinn-Shing
authors: SS
authors: Lee
mesh_terms: D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000000981:diagnostic imaging*; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D018084:Ultrasonography, Interventional; D014630:Vagus Nerve / Q000033:anatomy & histology* / Q000502:physiology
keywords: Intraoperative monitoring; Ultrasonography; Vagus nerve