Surgical anatomy of the internal branch of the superior laryngeal nerve

Kiray, Amac; Naderi, Sait; Ergur, Ipek; Korman, Esin

doi:10.1007/s00586-005-0006-7

Cited by 36 publications

(37 citation statements)

References 17 publications

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“…This is identical to the mechanism underlying the carotid massage technique for supraventricular tachyarrhythmias . The laryngeal surface of the epiglottis is innervated by a general sensory branch of the vagus nerve: the internal branch of the superior laryngeal nerve . Alternatively, it has been proposed that stimulation of this nerve may trigger an efferent parasympathetic vagal response to the sinoatrial node of the heart, which decreases conduction and results in significant bradycardia .…”

Section: Discussionmentioning

confidence: 84%

Severe bradycardia associated with suspension laryngoscopy

et al. 2015

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Suspension laryngoscopy is one of the most common procedures performed for visualizing and diagnosing diseases of the larynx. A relatively uncommon yet potentially life-threatening complication is that of severe bradycardia or asystole during manipulation of the larynx. This case report highlights the occurrence of this complication during a routine removal of a true vocal fold lesion at a tertiary medical center and discusses the potential pathophysiological mechanisms and proposed management options for this phenomenon.

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Section: Discussionmentioning

confidence: 84%

Severe bradycardia associated with suspension laryngoscopy

et al. 2015

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“…The ISLN is sensory to the laryngeal mucosa down to the level of the vocal folds. Injury to the ISLN causes a loss in cough reflex [8,12,13]. Hill et al [14] recommended the superior to the superior horn of the ThC as the landmark of the ISLN at the larynx and it corresponded to C4 in this study.…”

Section: Discussionmentioning

confidence: 88%

Topographical anatomy of the anterior cervical approach for c2-3 level

et al. 2013

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“…[ 11 – 13 ] The SLN originates from the vagus nerve at the C1 and C2 levels of the vertebrae and divides into internal and external branches beneath the internal carotid artery at the C2 level. [ 26 ] The internal branch runs inferior or lateral to the greater horn of the hyoid with rare variation [ 10 ] and provides sensory innervation to the larynx after penetration of the thyrohyoid membrane (Fig. 1 ).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided superior laryngeal nerve block assists in anesthesia for bronchoscopic surgical procedure

Liao¹,

Hsieh³

et al. 2020

Medicine

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Introduction: Evolving techniques in the field of therapeutic bronchoscopy have led to the return of rigid bronchoscopy in the treatment of complex central airway disease. Rigid bronchoscopy is typically performed under general anesthesia because of the strong stimulation caused by metal instruments. Anesthesia for rigid bronchoscopy is challenging to administer because anesthesiologists and interventionists share the same working channel: the airway. Previously reviewed anesthetic methods are used primarily for short procedures. Balanced anesthesia with ultrasound-guided superior laryngeal nerve (SLN) block and total intravenous anesthesia might provide anesthesia for a prolonged procedure and facilitate patient recovery. Patient concerns: A patient with obstructed endobronchial stent was referred for therapeutic rigid bronchoscopy, which requires deeper anesthesia than flexible bronchoscopy. There were concerns of the stronger stimulation of the rigid bronchoscopy, lengthy duration of the procedure, higher risk of hypoxemia, and the difficulty of mechanical ventilation weaning after anesthesia due to the patients co-morbidities. Diagnosis: A 66-year-old female patient presented with a history of breast cancer with lung metastases. Right main bronchus obstruction due to external compression of lung metastases was relieved through insertion of an endobronchial stent, but obstructive granulation developed after 4 months. Presence of the malfunctioning stent caused severe cough and discomfort. Removal of the stent by using a flexible bronchoscope was attempted twice but failed. Interventions: Regional anesthesia of the upper airway through ultrasound-guided SLN block combined with intratracheal 2% lidocaine spray was performed to assist in total intravenous anesthesia (TIVA) during rigid bronchoscopy. Outcomes: The patient maintained steady spontaneous breathing throughout the procedure without laryngospasm, bucking, or desaturation. Emergence from anesthesia was smooth and rapid after propofol infusion was discontinued. The surgery lasted 2.5 hours without discontinuity, and no perioperative pulmonary or cardiovascular complications were noted. Conclusion: Ultrasound-guided SLN block is a simple technique with a high success rate and low complication rate. Application of SLN block to assist TIVA provides sufficient anesthesia for lengthened therapeutic rigid bronchoscopy without interruption and facilitates patient recovery.

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Surgical anatomy of the internal branch of the superior laryngeal nerve

Cited by 36 publications

References 17 publications

Severe bradycardia associated with suspension laryngoscopy

Severe bradycardia associated with suspension laryngoscopy

Topographical anatomy of the anterior cervical approach for c2-3 level

Ultrasound-guided superior laryngeal nerve block assists in anesthesia for bronchoscopic surgical procedure

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