Nakayama M, Hirose H, Okamoto M, Miyamoto S, Yokobori S, Takeda M, Seino Y, Kawashima E
Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
J Laryngol Otol. 2007 Jan;121(1):87-91. doi: 10.1017/S002221510600315X. Epub 2006 Oct 13.
Two patients who received supracricoid laryngectomy with cricohyoidoepiglottopexy to treat laryngeal cancers, underwent intra-operative electromyography analysis. After the lesion was removed and the electrodes were inserted into the remaining intrinsic laryngeal muscles, the depth of anaesthesia was carefully reduced. Gentle tactile stimulations were applied to the pharynx to trigger the reflex movement of the remaining arytenoids. Recordings were made when reflex movement was achieved. Case one: Electromyography (EMG) of the remaining arytenoid demonstrated clear phase differences indicating reciprocal activities between the adductor group (lateral cricoarytenoid muscle, interarytenoid muscle) and the abductor muscle (posterior cricoarytenoid muscle). Case two: EMG of the remaining arytenoid demonstrated reciprocal activities between the interarytenoid muscle and the posterior cricoarytenoid muscle. Activity of the lateral cricoarytenoid muscle was not evident because the muscle was excised during removal of the paraglottic space. Mobility of the arytenoid was attributed to interaction between the interarytenoid muscle and posterior cricoarytenoid muscle. Reciprocal interaction between the interarytenoid muscle and posterior cricoarytenoid muscle alone is also capable of maintaining post-operative laryngeal functions after supracricoid laryngectomy with cricohyoidoepiglottopexy.
两名接受环状软骨上喉切除术联合环状软骨舌骨会厌固定术治疗喉癌的患者，接受了术中肌电图分析。在切除病变组织并将电极插入剩余的喉内肌后，小心降低麻醉深度。对咽部进行轻柔的触觉刺激，以触发剩余杓状软骨的反射运动。当实现反射运动时进行记录。病例一：剩余杓状软骨的肌电图（EMG）显示出明显的相位差异，表明内收肌群（环杓侧肌、杓间肌）和外展肌（环杓后肌）之间存在相互活动。病例二：剩余杓状软骨的EMG显示杓间肌和环杓后肌之间存在相互活动。环杓侧肌的活动不明显，因为在切除声门旁间隙时该肌肉被切除。杓状软骨的活动归因于杓间肌和环杓后肌之间的相互作用。仅杓间肌和环杓后肌之间的相互作用也能够在环状软骨上喉切除术联合环状软骨舌骨会厌固定术后维持喉功能。
