119 lines
No EOL
29 KiB
XML
119 lines
No EOL
29 KiB
XML
<?xml version="1.0" encoding="utf-8"?>
|
|
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
|
|
|
|
<head><meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
|
|
<!-- AppResources meta begin -->
|
|
<meta name="paf-app-resources" content="" />
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- AppResources meta end -->
|
|
|
|
<!-- TemplateResources meta begin -->
|
|
<meta name="paf_template" content="" />
|
|
|
|
<!-- TemplateResources meta end -->
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books" /><meta name="ncbi_pdid" content="book-part" /><meta name="ncbi_acc" content="NBK545231" /><meta name="ncbi_domain" content="statpearls" /><meta name="ncbi_report" content="printable" /><meta name="ncbi_type" content="fulltext" /><meta name="ncbi_objectid" content="" /><meta name="ncbi_pcid" content="/NBK545231/?report=printable" /><meta name="ncbi_app" content="bookshelf" />
|
|
<!-- Logger end -->
|
|
|
|
<title>Anatomy, Head and Neck: Larynx Muscles - StatPearls - NCBI Bookshelf</title>
|
|
|
|
<!-- AppResources external_resources begin -->
|
|
<link rel="stylesheet" href="/core/jig/1.15.2/css/jig.min.css" /><script type="text/javascript" src="/core/jig/1.15.2/js/jig.min.js"></script>
|
|
|
|
<!-- AppResources external_resources end -->
|
|
|
|
<!-- Page meta begin -->
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="StatPearls [Internet]" /><meta name="citation_title" content="Anatomy, Head and Neck: Larynx Muscles" /><meta name="citation_publisher" content="StatPearls Publishing" /><meta name="citation_date" content="2023/08/08" /><meta name="citation_author" content="Kaysie Junco" /><meta name="citation_author" content="Swapna K. Chandran" /><meta name="citation_pmid" content="31424815" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK545231/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Anatomy, Head and Neck: Larynx Muscles" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="StatPearls Publishing" /><meta name="DC.Contributor" content="Kaysie Junco" /><meta name="DC.Contributor" content="Swapna K. Chandran" /><meta name="DC.Date" content="2023/08/08" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK545231/" /><meta name="description" content="The larynx consists of an intricate array of muscles, ligaments, and cartilaginous structures that provide several vital functions. These vary from the protection of the airway during swallowing to the production of voice. Thhis activity will discuss the anatomy and function of these structures and how they interact with one another. Furthermore, it will explore the significant clinical implications in regards to surgical and anesthetic considerations.[1]" /><meta name="og:title" content="Anatomy, Head and Neck: Larynx Muscles" /><meta name="og:type" content="book" /><meta name="og:description" content="The larynx consists of an intricate array of muscles, ligaments, and cartilaginous structures that provide several vital functions. These vary from the protection of the airway during swallowing to the production of voice. Thhis activity will discuss the anatomy and function of these structures and how they interact with one another. Furthermore, it will explore the significant clinical implications in regards to surgical and anesthetic considerations.[1]" /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK545231/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-statpearls-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/statpearls/article-17871/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK545231/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
|
|
|
|
<!-- Page meta end -->
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico" /><meta name="ncbi_phid" content="CE8C40D67D86C4810000000000680053.m_5" />
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3985586/3808861/4121862/3974050/3917732/251717/4216701/14534/45193/4113719/3849091/3984811/3751656/4033350/3840896/3577051/3852958/3984801/12930/3964959.css" /><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3411343/3882866.css" media="print" /></head>
|
|
<body class="book-part">
|
|
<div class="grid no_max_width">
|
|
<div class="col twelve_col nomargin shadow">
|
|
<!-- System messages like service outage or JS required; this is handled by the TemplateResources portlet -->
|
|
<div class="sysmessages">
|
|
<noscript>
|
|
<p class="nojs">
|
|
<strong>Warning:</strong>
|
|
The NCBI web site requires JavaScript to function.
|
|
<a href="/guide/browsers/#enablejs" title="Learn how to enable JavaScript" target="_blank">more...</a>
|
|
</p>
|
|
</noscript>
|
|
</div>
|
|
<!--/.sysmessage-->
|
|
<div class="wrap">
|
|
<div class="page">
|
|
<div class="top">
|
|
|
|
<div class="header">
|
|
|
|
|
|
</div>
|
|
|
|
|
|
|
|
<!--<component id="Page" label="headcontent"/>-->
|
|
|
|
</div>
|
|
<div class="content">
|
|
<!-- site messages -->
|
|
<div class="container content">
|
|
<div class="document">
|
|
<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. </p></div></div></div>
|
|
<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK545231_"><span class="title" itemprop="name">Anatomy, Head and Neck: Larynx Muscles</span></h1><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Kaysie Junco</span><sup>1</sup>; <span itemprop="author">Swapna K. Chandran</span><sup>2</sup>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> CUSOM</div><div class="affiliation"><sup>2</sup> University of Louisville</div><p class="small">Last Update: <span itemprop="dateModified">August 8, 2023</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="article-17871.s1"><h2 id="_article-17871_s1_">Introduction</h2><p>The larynx consists of an intricate array of muscles, ligaments, and cartilaginous structures that provide several vital functions. These vary from the protection of the airway during swallowing to the production of voice. Thhis activity will discuss the anatomy and function of these structures and how they interact with one another. Furthermore, it will explore the significant clinical implications in regards to surgical and anesthetic considerations.<a class="bk_pop" href="#article-17871.r1">[1]</a></p></div><div id="article-17871.s2"><h2 id="_article-17871_s2_">Structure and Function</h2><p>The larynx has a cartilaginous framework that houses the muscles and ligaments that are primarily and uniquely designed to prevent the aspiration of ingested material into the airway. These same structures are involved in the production of voice as airflow from the lungs passes through the vocal folds (housed in the larynx) and creates various frequencies of sound that can ultimately produce a person's unique voiceprint. The larynx subdivides into three parts: the supraglottis (the epiglottis and false or ventricular folds), the glottis (the true vocal folds) and the subglottis. Any alteration in the function of the larynx can affect breathing, swallowing, or voice. </p></div><div id="article-17871.s3"><h2 id="_article-17871_s3_">Embryology</h2><p>As mentioned earlier, the larynx is a multifaceted assembly made up of components that systematically work together to provide vital physiologic functions. The developing larynx arises from branchial structures around the fourth week of gestation. Arising from both the endoderm and mesoderm, several pharyngeal arches give rise to the larynx and its associated structures. More specifically these pharyngeal arches are the third (develops into cranial nerve IX and greater horn of hyoid), fourth (superior laryngeal nerve, thyroid cartilage, cuneiform cartilage, cricopharyngeus muscle, and cricothyroid muscle) and sixth (recurrent laryngeal nerve, cricoid cartilage, arytenoid cartilages, corniculate cartilages, intrinsic laryngeal muscles).</p><p>The larynx develops from an outgrowth opening around the fourth week of gestation, termed the laryngotracheal groove. As this groove continues to elongate and progress, the epiglottis and laryngeal inlet begin to appear. Eventually, a septum develops and begins to fuse around the twenty-fifth day of gestation which separates the laryngeal inlet into two distinct compartments, this is the esophagotracheal septum or laryngotracheal septum and arises from the fusion of the tracheoesophageal fold.</p><p>The final arrangement following this separation results in a tubular structure (the esophagus) that lies posteriorly, while another tubular structure (the developing respiratory tract) sits anteriorly. Subsequently, there is an additional outpouching, known as the laryngotracheal diverticulum, from the anterior tubular structure which becomes the future larynx, trachea, and lungs.<a class="bk_pop" href="#article-17871.r2">[2]</a><a class="bk_pop" href="#article-17871.r3">[3]</a><a class="bk_pop" href="#article-17871.r4">[4]</a> </p></div><div id="article-17871.s4"><h2 id="_article-17871_s4_">Blood Supply and Lymphatics</h2><p>The larynx is a well-vascularized tubular structure that receives its blood supply from several major vessels. On either side, the larynx receives vascular supply from the right and left common carotid arteries which bifurcate into the internal and external carotid arteries. The first branch from the external carotid artery is the superior thyroid artery. This artery further divides into the superior laryngeal artery, which pierces the thyrohyoid membrane to supply the intrinsic muscles of the larynx, and the cricothyroid branch that supplies the cricothyroid muscle. Venous drainage is accomplished ultimately by the internal jugular vein which divides into the corresponding vessels of the superior thyroid vein as well as both the superior and inferior laryngeal veins. Lymphatic drainage occurs through a combination of deep cervical lymph nodes such as the anterior cervical and lateral jugular lymph nodes which terminate at the right lymphatic duct and thoracic duct.<a class="bk_pop" href="#article-17871.r4">[4]</a></p></div><div id="article-17871.s5"><h2 id="_article-17871_s5_">Nerves</h2><p>The laryngeal muscles receive innervation from two nerves, the external branch of the superior laryngeal nerve and the recurrent laryngeal nerve. These nerves both arise from the vagus nerve (cranial nerve X) and provide both motor and sensory innervation to the intrinsic muscles of the larynx, excluding the interarytenoid muscles. The cricothyroid muscle is innervated solely by the external branch of the superior laryngeal nerve while the recurrent laryngeal provides motor innervates to the other intrinsic laryngeal muscles. The internal branch of superior laryngeal nerve supplies sensory to the mucosa of the larynx. The nucleus ambiguous within the brain stem provides the motoneurons to the intrinsic laryngeal muscles while the hypoglossal nucleus provides the motoneurons to extrinsic muscles.<a class="bk_pop" href="#article-17871.r5">[5]</a> The recurrent laryngeal branch of the vagus nerve descends in the neck and on the left side loops around the aorta before ascending and entering the cricothyroid membrane to innervate the muscles. On the right the nerve loops around the subclavian and ascends to enter the larynx. Non-recurrent anatomic variants on the right do exist.</p></div><div id="article-17871.s6"><h2 id="_article-17871_s6_">Muscles</h2><p>Comprising the larynx are both intrinsic and extrinsic muscles that play a part in the manipulation of air movement, swallowing, and the production of voice. These muscles participate in the orchestrated control of vocal cord abduction, adduction, and lengthening. The four paired, and one unpaired intrinsic muscles are those which are localized to the larynx while extrinsic muscles involve those which attach to both the larynx and other proximity structures. These intrinsic muscles of the larynx include the paired thyroarytenoid, lateral cricoarytenoid, posterior cricoarytenoid, and cricothyroid muscles and the unpaired interarytenoid muscle — all the intrinsic muscles except the posterior cricoarytenoid act to adduct the vocal folds. The action of abduction is a result of posterior cricoarytenoid activation. The cricothyroid muscle is unique in that it elongates the vocal cords as well, which creates tension on the vocal cords and assists in high pitch phonation. The extrinsic muscles of the larynx such as the thyrohyoid (which raises the thyroid cartilage) and the sternothyroid muscle (which lowers the thyroid cartilage) function to manipulate the position of the larynx during swallowing or pitch control during phonation.<a class="bk_pop" href="#article-17871.r5">[5]</a><a class="bk_pop" href="#article-17871.r6">[6]</a><a class="bk_pop" href="#article-17871.r7">[7]</a></p></div><div id="article-17871.s7"><h2 id="_article-17871_s7_">Physiologic Variants</h2><p>As with any anatomical structure of the body, there exists the potential for variants. Such variants can arise as congenital malformations leading to impaired respiratory function in the neonate. One such anomaly involves the presence of laryngeal clefts in the newborn, which can pose a risk for aspiration and respiratory distress. Such clefts are a result of a failed separation of the previously mentioned laryngotracheal septum leading to a lack of separation between the larynx/trachea and the esophagus. Other considerations occur when there is incomplete canalization of the developing larynx leading to various degrees of obstruction of the airway, which should be a consideration in an infant that develops respiratory distress.</p><p>Variations also exist anatomically with the neurovascular arrangement of the laryngeal structures. Cases of a nonrecurrent inferior laryngeal nerve have been recorded on the right, representing a rare anatomical anomaly thought to be a result of the fourth branchial arch involuting instead of persisting as the subclavian artery.  The nonrecurrent laryngeal nerve then branches directly off the cervical vagus.  The positional relationship between the recurrent laryngeal nerve and the inferior thyroid artery can vary in position with the recurrent laryngeal nerve sitting either posterior, anterior, or between branches of the inferior thyroid artery. The branching pattern of the recurrent laryngeal nerve can also vary from two to many branches within the musculature and cartilaginous framework. In general, all of these varieties are important when considering thyroid or other laryngotracheal surgical operations.<a class="bk_pop" href="#article-17871.r8">[8]</a><a class="bk_pop" href="#article-17871.r3">[3]</a></p></div><div id="article-17871.s8"><h2 id="_article-17871_s8_">Surgical Considerations</h2><p>Iatrogenic causes of injury to the vagus nerve and its branches can lead to a unilateral paresis or paralysis of the vocal fold. Recurrent laryngeal nerve damage can be a complication in operations such as thyroid surgery where unilateral damage leads to hoarseness or swallowing difficulties. Damage to the external branch of the superior laryngeal nerve can lead to an inability to increase pitch as the cricothyroid is unable to lengthen the vocal folds. Bilateral damage to the nerves, while extremely uncommon, can have severe sequelae of respiratory distress (secondary to failure of abduction and resultant midline position of the vocal folds) and occasionally can lead to a tracheostomy.<a class="bk_pop" href="#article-17871.r7">[7]</a><a class="bk_pop" href="#article-17871.r8">[8]</a><a class="bk_pop" href="#article-17871.r5">[5]</a><a class="bk_pop" href="#article-17871.r9">[9]</a> </p><p>During endotracheal intubation, the endotracheal tube passes through the vocal folds, and the end ultimately rests in the subglottic larynx.  Ischemic damage from the pressure of the endotracheal tube through weaknesses in the cartilaginous framework can occur and ultimately cause sequela to the recurrent laryngeal nerve, resulting in apraxia that usually resolves with time.  Further insults of the passage of the endotracheal tube through the larynx involve damage or hemorrhage to the vocal folds and possible glottic and subglottic inflammation and subsequent scar formation.  This scar formation may obstruct the airway and lead to distress in the long-term. </p></div><div id="article-17871.s9"><h2 id="_article-17871_s9_">Clinical Significance</h2><p>There are a variety of important implications when considering the surgical, anesthetic, and clinical significance of the larynx. Clinical evaluation of the larynx in any patient with voice, swallowing, or airway symptoms is vital to determine functional or anatomic anomalies that may be a cause. Understanding the anatomy and function of the organ and its impact on the complex orchestration of swallowing and voicing will better equip the clinician to educate and treat patients with disorders of the upper aerodigestive tract.</p></div><div id="article-17871.s10"><h2 id="_article-17871_s10_">Review Questions</h2><ul><li class="half_rhythm"><div>
|
|
<a href="https://www.statpearls.com/account/trialuserreg/?articleid=17871&utm_source=pubmed&utm_campaign=reviews&utm_content=17871" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Access free multiple choice questions on this topic.</a>
|
|
</div></li><li class="half_rhythm"><div>
|
|
<a href="https://www.statpearls.com/articlelibrary/commentarticle/17871/?utm_source=pubmed&utm_campaign=comments&utm_content=17871" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Comment on this article.</a>
|
|
</div></li></ul></div><div class="floats-group" id="article-17871.s11"></div><div id="article-17871.s12"><h2 id="_article-17871_s12_">References</h2><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="article-17871.r1">Fregosi RF, Ludlow CL. Activation of upper airway muscles during breathing and swallowing. <span><span class="ref-journal">J Appl Physiol (1985). </span>2014 Feb 01;<span class="ref-vol">116</span>(3):291-301.</span> [<a href="/pmc/articles/PMC3921357/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3921357</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24092695" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24092695</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="article-17871.r2">Kotecha V, Muturi A, Ruturi J. Branchial cysts: an unusual cause of a mediastinal mass: a case report. <span><span class="ref-journal">J Med Case Rep. </span>2015 Sep 29;<span class="ref-vol">9</span>:208.</span> [<a href="/pmc/articles/PMC4587576/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4587576</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26416666" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26416666</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="article-17871.r3">Corbally MT. Laryngo-tracheo-oesophageal cleft. <span><span class="ref-journal">Arch Dis Child. </span>1993 May;<span class="ref-vol">68</span>(5 Spec No):532-3.</span> [<a href="/pmc/articles/PMC1029297/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1029297</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/8323350" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8323350</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="article-17871.r4">Saran M, Georgakopoulos B, Bordoni B. <span class="ref-journal">StatPearls [Internet].</span> StatPearls Publishing; Treasure Island (FL): Aug 7, 2023. Anatomy, Head and Neck, Larynx Vocal Cords. [<a href="https://pubmed.ncbi.nlm.nih.gov/30570963" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30570963</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="article-17871.r5">Simonyan K, Horwitz B. Laryngeal motor cortex and control of speech in humans. <span><span class="ref-journal">Neuroscientist. </span>2011 Apr;<span class="ref-vol">17</span>(2):197-208.</span> [<a href="/pmc/articles/PMC3077440/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3077440</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21362688" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21362688</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="article-17871.r6">Ludlow CL. Central nervous system control of the laryngeal muscles in humans. <span><span class="ref-journal">Respir Physiol Neurobiol. </span>2005 Jul 28;<span class="ref-vol">147</span>(2-3):205-22.</span> [<a href="/pmc/articles/PMC1351146/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1351146</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15927543" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15927543</span></a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="article-17871.r7">Kim SW, Kim ST, Park HS, Lee HS, Hong JC, Kwon SB, Lee KD. Voice examination in patients with decreased high pitch after thyroidectomy. <span><span class="ref-journal">Indian J Otolaryngol Head Neck Surg. </span>2012 Jun;<span class="ref-vol">64</span>(2):120-30.</span> [<a href="/pmc/articles/PMC3392351/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3392351</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23730571" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23730571</span></a>]</div></dd><dt>8.</dt><dd><div class="bk_ref" id="article-17871.r8">Wojtczak B, Kaliszewski K, Sutkowski K, Bolanowski M, Barczyński M. A functional assessment of anatomical variants of the recurrent laryngeal nerve during thyroidectomies using neuromonitoring. <span><span class="ref-journal">Endocrine. </span>2018 Jan;<span class="ref-vol">59</span>(1):82-89.</span> [<a href="/pmc/articles/PMC5765187/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5765187</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29119329" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29119329</span></a>]</div></dd><dt>9.</dt><dd><div class="bk_ref" id="article-17871.r9">Wojtczak B, Sutkowski K, Kaliszewski K, Forkasiewicz Z, Knychalski B, Aporowicz M, Bolanowski M, Barczyński M. Voice quality preservation in thyroid surgery with neuromonitoring. <span><span class="ref-journal">Endocrine. </span>2018 Aug;<span class="ref-vol">61</span>(2):232-239.</span> [<a href="/pmc/articles/PMC6061215/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6061215</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29730784" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29730784</span></a>]</div></dd></dl></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin">
|
|
<b>Disclosure: </b>Kaysie Junco declares no relevant financial relationships with ineligible companies.</p></div></dd><dt></dt><dd><div><p class="no_top_margin">
|
|
<b>Disclosure: </b>Swapna Chandran declares no relevant financial relationships with ineligible companies.</p></div></dd></dl></div><div class="bk_prnt_sctn"><h2>Figures</h2><div class="whole_rhythm bk_prnt_obj bk_first_prnt_obj"><div id="article-17871.image.f1" class="figure bk_fig"><div class="graphic"><img src="/books/NBK545231/bin/laryngeal__muscles.jpg" alt="Image laryngeal__muscles" /></div><div class="caption"><p>Laryngeal muscles Image courtesy Dr Chaigasame</p></div></div></div></div></div></div>
|
|
<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2025, StatPearls Publishing LLC.<p class="small">
|
|
This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
|
|
(<a href="https://creativecommons.org/licenses/by-nc-nd/4.0/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=uri">
|
|
http://creativecommons.org/licenses/by-nc-nd/4.0/
|
|
</a>), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.
|
|
</p></div><div class="small"><span class="label">Bookshelf ID: NBK545231</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/31424815" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">31424815</a></span></div></div></div>
|
|
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="bottom">
|
|
|
|
<div id="NCBIFooter_dynamic">
|
|
<!--<component id="Breadcrumbs" label="breadcrumbs"/>
|
|
<component id="Breadcrumbs" label="helpdesk"/>-->
|
|
|
|
</div>
|
|
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </script>
|
|
</div>
|
|
</div>
|
|
<!--/.page-->
|
|
</div>
|
|
<!--/.wrap-->
|
|
</div><!-- /.twelve_col -->
|
|
</div>
|
|
<!-- /.grid -->
|
|
|
|
<span class="PAFAppResources"></span>
|
|
|
|
<!-- BESelector tab -->
|
|
|
|
|
|
|
|
<noscript><img alt="statistics" src="/stat?jsdisabled=true&ncbi_db=books&ncbi_pdid=book-part&ncbi_acc=NBK545231&ncbi_domain=statpearls&ncbi_report=printable&ncbi_type=fulltext&ncbi_objectid=&ncbi_pcid=/NBK545231/?report=printable&ncbi_app=bookshelf" /></noscript>
|
|
|
|
|
|
<!-- usually for JS scripts at page bottom -->
|
|
<!--<component id="PageFixtures" label="styles"></component>-->
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal105 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3879255/4121861/3501987/4008961/3893018/3821238/3400083/3426610.js" snapshot="books"></script></body>
|
|
</html> |