The thyroarytenoid, posterior cricoarytenoid, lateral cricoarytenoid, and interarytenoid muscles can also be examined by using hooked-wire electrodes positioned indirectly under optic guidance or directly in the operating room.

The transoral LEMG examination begins after topical application of lidocaine transorally onto the mucosa of the soft palate, the pharynx, and the larynx in order to decrease the pharyngeal reflex. Additionally, the systemic application of Robinul is possible to decrease the salivation.

The use of either a flexible fiberoptic laryngoscope through the nose or a rigid laryngoscope through the mouth is essential depending on the need of the patient and the experience of the physician.

It is recommended to begin the LEMG with the

  • thyroarytenoid muscle (TA), followed by an examination
  • of┬áthe PCA if there is a good level of tolerance.
  • A transoral EMG of the cricothyroid muscle (CT) is not possible.