Division of Phoniatrics, Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria.
Eur Arch Otorhinolaryngol. 2023 Jun;280(6):2877-2883. doi: 10.1007/s00405-023-07843-y. Epub 2023 Feb 11.
The anterior, percutaneous Botulinum neurotoxin (BoNT) injection in the lateral cricoarytenoid muscle (LCA) guided by laryngeal electromyography (LEMG) is considered the golden standard treatment for several neurolaryngological disorders. The study presented in this article aims to assess the effectiveness of an alternative approach by which the injection is performed laterally under ultrasound monitoring.
Anatomical dissection study in human cadavers.
Academic health care center.
Ultrasound-guided bilateral dye (0.1 mL of dye solution containing cold-curing polymers, latex, acrylates, acrylic esters, alcohol, and green color) injection in the LCA was performed by means of 24G needles and 1 mL syringes using the lateral approach. The dye location and distribution were assessed by anatomic dissection, performed immediately after the injection.
In 9/10 specimens, the dye was exclusively detectable in the LCA. In 1/10 case (left side), the dye could not be delivered in the LCA because of unintended penetration of the thyroid cartilage by the needle during injection. Anatomic dissection confirmed that the dye spread neither into the thyroarytenoid (TA) nor the cricothyroid muscle (CT).
The anatomic dissection following lateral dye injection in the LCA under ultrasound guide confirmed the precision of this approach in delivery a substance exclusively in a pre-determined target. This feature makes this method an interesting addition or alternative to the standard LEMG-guided BoNT injection at least when the LCA is its target.
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经喉肌电图（LEMG）引导的前侧经皮肉毒毒素（BoNT）注射于外侧环杓肌（LCA）被认为是多种神经喉科疾病的金标准治疗方法。本文研究旨在评估一种替代方法的有效性，该方法通过超声监测进行侧向注射。
人体尸体解剖研究。
学术医疗中心。
使用 24G 针和 1mL 注射器通过外侧入路进行双侧染料（含冷固聚合物、乳胶、丙烯酸酯、丙烯酸酯、酒精和绿色染料的 0.1mL 染料溶液）超声引导 LCA 注射。注射后立即进行解剖学解剖，评估染料的位置和分布。
在 10 个标本中的 9 个中，LCA 中仅可检测到染料。在 1/10 的病例（左侧）中，由于注射时针头意外穿透甲状腺软骨，无法将染料注入 LCA。解剖学解剖证实染料既没有扩散到杓状软骨（TA）也没有扩散到环甲肌（CT）。
超声引导下 LCA 外侧染料注射后的解剖学解剖证实了这种方法在将物质精确输送到预定目标中的准确性。当 LCA 是其目标时，这种方法至少是 LEMG 引导的 BoNT 注射的一种有趣的补充或替代方法。
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