Laryngeal electromyography: a proposal for guidelines of the European Laryngological Society

Abstract

Although recognized as a valuable diagnostic tool for more than 60 years, many laryngologists do not routinely use laryngeal electromyography (LEMG). This may be due to a persisting lack of agreement on methodology, interpretation, validity, and clinical application of LEMG. To achieve consensus in these fields, a laryngeal electromyography working group of European neurolaryngologic experts was formed in order to (1) evaluate guidelines for LEMG performance and (2) identify issues requiring further clarification. To obtain an overview of existing knowledge and research, English-language literature about LEMG was identified using Medline. Additionally, cited works not detected in the initial search were screened. Evidence-based recommendations for the performance and interpretation of LEMG and also for electrostimulation for functional evaluation were considered, as well as published reports based on expert opinion and single-institution retrospective case series. To assess the data obtained by this literature evaluation, the working group met five times and performed LEMG together on more than 20 patients. Subsequently, the results were presented and discussed at the 8th Congress of the European Laryngological Society in Vienna, Austria, September 1-4, 2010, and consensus was achieved in the following areas: (1) minimum requirements for the technical equipment required to perform and record LEMG; (2) best practical implementation of LEMG; (3) criteria for interpreting LEMG. Based on this consensus, prospective trials are planned to improve the quality of evidence guiding the proceedings of practitioners.

Effects of thiopentone, propofol and alfaxalone on laryngeal motion during oral laryngoscopy in healthy dogs

“…It requires technical equipment as well as specialised knowledge of methodology and interpretation. Furthermore, its validity and clinical application is still questionable within human medicine (Volk et al 2012). Change in NGGA has been applied in few studies investigating the effect of anaesthetic protocols on laryngeal examination in healthy animals , Nelissen et al 2012.…”

Laryngeal Electromyography: Are the Results Reproducible?

“…12,13 Currently, LEMG is being widely used to identify presbylarynx of paresis 14 and to study the severity of dysphagia, 15 but it needs to be compared across studies before being incorporated into standard procedures as proposed by the Working Group on Neurolaryngology of the European Laryngological Society. 16,17 …”

Laryngeal Reflexes

“…Later the Neurolaryngology Study Group of the American Academy of Otolaryngology –Head and neck Surgery conducted a further review and found that laryngeal EMG could only be used for qualitative EMG (Blitzer, Crumley, Dailey, et al, 2009). The European Laryngological Society provided a description of the methods and techniques currently available for laryngeal electromyography and recommended workshops be provided to provide training for larynoglogists on its use in clinical practice for diagnosis of superior laryngeal nerve injury (cricothyroid muscle) and recurrent laryngeal nerve injury (the thyroarytenoid muscle)(Volk, Hagen, Pototschnig, et al., 2012). As follow-up the use of a training workshop for allowing practitioners to develop skills in the practice and interpretation of laryngeal EMG showed encouraging results indicating improved reliability with training (Volk, Pototschnig, Mueller, et al, 2015).…”