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The Innervation of the Posterior Cricoarytenoid Muscle: Exploring Clinical Possibilities
Journal article

The Innervation of the Posterior Cricoarytenoid Muscle: Exploring Clinical Possibilities

Robert L. Eller, Matthew Miller, Jeffrey Weinstein and Robert. T. Sataloff
Journal of voice, v 23(2), pp 229-234
2009
DOI: https://doi.org/10.1016/j.jvoice.2007.01.007
PMID: 17509824
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Abductor spasmodic dysphonia Anatomy Laryngeal BOTOX Laryngeal innervation Myectomy Neurectomy Neurolaryngology Posterior cricoarytenoid Recurrent laryngeal nerve Reinnervation Spasmodic dysphonia Vocal cord Vocal fold
Manipulation of the nerve supply to the posterior cricoarytenoid (PCA) muscle has potential for ameliorating the symptoms of some neurologic conditions such as abductor spasmodic dysphonia. The anatomy of the nerve supply to the PCA is better understood than in previous eras, but the anatomical understanding has not translated to clinical application yet. Microscopic dissection allowed the identification and measurement of the branches from the recurrent laryngeal nerves (RLNs) to the PCA in 43 human cadaver larynges. The cricothyroid (CT) joint was the primary landmark for measurement. Other structural measurements were also made on the larynges. All of the PCA muscles received innervation from the anterior division of the RLN. The number of direct branches from the RLN ranged from 1 to 5 (average 2.3) More than 70% of PCA muscles also received 1–3 branches off of the branch to the interarytenoid (IA) muscle. Less than half of PCA muscles received any kind of nerve branches from the posterior division of the RLN. Branches to the PCA most commonly departed the main RLN in its vertical segment and all entered the muscle from its deep surface. All branches departed the RLN within an average of 9.5 mm from the CT joint; the branch to the IA occurs distal to this point. The innervation to the PCA is complex and redundant, and the segment of the RLN supplying those branches is difficult to expose safely. For these reasons, selective denervation or reinnervation procedures limited to the nerve branches may be technically difficult. When needing only to denervate the PCA, this can be accomplished by removing a portion of the PCA and the underlying nerve supply. Surgical technique should be based upon the understanding of the anatomy of the PCA muscle and its nerve supply.

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12 citations in Web of Science
14 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Audiology & Speech-language Pathology
Otorhinolaryngology
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