Value of laryngeal electromyography in diagnosis of vocal fold immobility.
OBJECTIVE
We sought to determine the value of laryngeal electromyography (LEMG) and evoked LEMG in the diagnosis of vocal fold immobility.


METHODS
We analyzed 110 cases of vocal fold immobility by their clinical manifestations and LEMG characteristics, including spontaneous potential activity, motor unit potential measurement, recruitment pattern analysis, and evoked LEMG signals.


RESULTS
With LEMG, we identified 87 patients with neuropathic laryngeal injuries. Neurogenic vocal fold immobility showed a wide variety of abnormal activity. Fibrillation potentials and positive sharp waves were found in patients with laryngeal nerve injuries. For laryngeal paralysis, there was no reaction with LEMG and evoked LEMG. For incomplete laryngeal paralysis, decreased evoked LEMG signals were also seen with delayed latency (thyroarytenoid muscle, 2.2 +/- 1.0 ms, p < .01; posterior cricoarytenoid muscle, 2.4 +/- 1.0 ms, p < .05) and lower amplitude (thyroarytenoid muscle, 0.9 +/- 0.7 mV, p < .05; posterior cricoarytenoid muscle, 1.2 +/- 1.0 mV, p < .01). Nineteen patients with vocal fold mechanical limitations generally had normal LEMG and evoked LEMG signals. Four patients with neoplastic infiltration of the laryngeal muscles demonstrated abnormal LEMG signals but nearly normal evoked LEMG signals.


CONCLUSIONS
We conclude that LEMG and evoked LEMG behavior plays a crucial role in the diagnosis of vocal fold immobility. The decreased recruitment activities on LEMG and the decreased evoked LEMG signals with longer latency and lower amplitude reflect the severity of neuropathic laryngeal injury.
Xu
Wen
W
Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing. China.
Han
Demin
D
Hou
Lizhen
L
Zhang
Li
L
Zhao
Gongwei
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D004576:Electromyography / Q000379:methods*; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D007823:Laryngeal Nerves / Q000503:physiopathology; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D011999:Recruitment, Neurophysiological / Q000502:physiology; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology; D049489:Stroboscopy; D014826:Vocal Cord Paralysis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D014827:Vocal Cords / Q000503:physiopathology