Pediatric Voice and Swallowing Disorders Related to Vocal Fold Immobility: the Use of Laryngeal EMG

Pediatric Vocal Fold Paresis and Paralysis

“…the injury, laryngeal reinnervation can take from months to years in children and adults after the event. 6 The clinical profile of VFP is largely associated with the degree and pattern of reinnervation. For example, laryngeal muscles may be reinnervated by sprouting from surrounding intact nerves.…”

“…9,10 In pediatric patients, spontaneous RLN reinnervation of laryngeal muscles may be more common, but the incidence of laryngeal synkinesis has not been reported to date, to our knowledge. 6…”

“…[16][17][18][19][20]22 Laryngeal electromyography, completed with either hook wires or concentric needle electrodes, has been proposed as a diagnostic and prognostic tool for adults with VFP. 6 However, the lack of normative or baseline LEMG values specific to the pediatric population hinders its diagnostic and prognostic abilities. Also, concerns of using needle LEMG for children include its invasiveness and the need for general anesthesia.…”

“…Also, concerns of using needle LEMG for children include its invasiveness and the need for general anesthesia. 6,19 Despite its limitations, LEMG is considered to be rather safe and reliable for the pediatric population and is sometimes helpful in determining the prognosis and treatment plans (Table 1). [16][17][18][19][20]23 Because nerve injury and regeneration may not be reliably detected at early, acute stages, a proposal is to perform an LEMG examination between 4 weeks and 6 months after suspected injury.…”

“…4 Spontaneous reinnervation after laryngeal nerve injury was evident in animal studies and clinical observation. 5,6 For instance, mild laryngeal injuries such as compression neuropathy are mostly associated with the disrupted conduction at the site of injury. In this case, full functional recovery is expected, as the nerve remains intact without axonal injury.…”