Predictive value of laryngeal electromyography in patients with vocal cord paralysis of neurogenic origin

Abstract

Laryngeal electromyography can provide prognostic information when evaluating patients with vocal cord dysfunction. Twenty-four patients were studied to determine the predictive capacity of this test. Six patients had bilateral vocal cord paralysis, constituting a total of 30 vocal cords examined. Sixteen of these cords had decreased or absent motor unit potentials, fibrillations, or positive waves. None of these patients recovered function. Fourteen cords demonstrated either normal motor unit or polyphasic potentials. Return of mobility was evident in 11 of these cords. The combined total was 27 of 30 cords correctly predicted, demonstrating a 90% accuracy rate.

Role of Laryngeal Electromyography in Predicting Recovery After Vocal Fold Paralysis

“…Initial patterns of indeterminate reinnervation/denervation (ongoing reinnervation and denervation) persisted for a period less than 12 weeks from onset of symptoms and usually followed the path of either recovery or complete palsy thereafter [9,10]. Earliest appearance of normal potentials induced by regeneration was at *80 days, which was consistent with earlier studies, a finding which has lead to the postulation that surgical intervention should be postponed until at least 80 days after the onset of paralysis [11].…”

“…The results supported the hypothesis that LEMG data can be used effectively to determine a prognosis for recovery of vocal fold motion [4,5,8,9]. The prognosis derived from LEMG predicted 68.3 % of patients who had resolved vocal fold movement.…”

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

“…Several reports have suggested that motor unit recruitment is the most valuable predictor of vocal fold movement [21, 23•]. Decreased motor unit potentials can be seen as a poor prognostic sign [34]. The 2016 consensus statement has shown that the presence of motor unit potentials increases the likelihood of recovery by 52.6 % [31••].…”

“…A turn is defined as a change in signal direction after the peak of a motor unit potential [34,39]. As software to perform turns analysis becomes more widespread, quantitative LEMG may have greater clinical value [35••].…”

Paralisia do músculo cricoaritenóideo lateral: relato de caso como contribuição ao estudo da anatomia funcional da laringe

“…Nos últimos anos a eletromiografia da laringe (EMG) vem sendo útil no diagnóstico das alterações de mobilidade das pregas vocais, sobretudo diferenciando as paralisias das fixações, e também fornecendo dados para o prognóstico e localização de lesões neuromusculares [1][2][3][4][5][6][7][8][9][10] , sendo um método objetivo de avaliação da atividade neuromuscular 3,11,12 . A paralisia da prega vocal pode ser resultado de lesão central ou periférica que envolve o nervo vago acima da saída do nervo laríngeo superior (NLS) ou mais distalmente, sem seu envolvimento, isto é, comprometendo apenas o nervo recorrente (NR).…”