A new method of needle-electrode placement in the posterior cricoarytenoid muscle for electromyography

In 1979 the authors developed a new method of needle-electrode placement in the posterior cricoarytenoid muscle (PCA) for electromyography. The PCA muscle is easily reached by inserting a needle electrode through the cricothyroid membrane at the midline and penetrating the lamina of the cricoid cartilage in the subglottic cavity. Access to the PCA muscle for electrode insertion was best afforded by a percartilaginous approach. This report details the new technique used at our laboratory. To our knowledge, this is the first report of needle-electrode placement in the PCA muscle by a percartilaginous approach. This new electrode insertion technique has been applied to more than 100 dogs for research purposes and to 1200 patients with laryngeal motor disorders for clinical diagnosis. This is a simple technique requiring the usual skills. Reliable electromyographic recordings have been obtained by this new method. No untoward effects, such as hematoma or infection from repeated placements were observed in approximately 3200 examinations performed to date. It is reasonable to assume that the percartilaginous route for electrode insertion in the PCA muscle is feasible in man. Techniques of electrode placement in the intrinsic laryngeal muscles are reviewed and compared.