title: Laryngeal electromyography for prognosis of vocal fold palsy: a meta-analysis.
abstract: OBJECTIVE
  To analyze existing evidence regarding utility of laryngeal electromyography (LEMG) for prognosis in cases of vocal fold palsy (VFP).
  
  
  METHODS
  Meta-analysis of studies reporting LEMG results and clinical outcomes in 503 patients with of VFP identified by literature search.
  
  
  METHODS
  Studies were identified by literature search. Method of diagnosis, interval to LEMG, criteria for prognostication, and outcome were assessed. Criteria for prognosis were standardized to the extent possible across all studies, and studies were checked for consistency in outcome measures and assessments. Pooled data were subjected to statistical analysis.
  
  
  RESULTS
  A total of 296/503 patients (58.8%) had findings predictive with poor prognosis, whereas 207/503 (41.2%) had findings of recovery. According to laryngoscopic examination, 269/296 patients with predicted poor recovery had poor recovery (positive predictive value=90.9%), whereas 27/296 (9.1%) had good recovery. In patients with findings consistent with recovery, 115/207 (negative predictive value=55.6%) noted return of motion, whereas 88/207 (44.4%) did not. The odds ratio was 11.56 with 95% confidence interval of 7.10-18.81.
  
  
  CONCLUSIONS
  LEMG is a good predictor of poor recovery in patients with VFP and is clinically useful in identifying candidates for early definitive intervention.
authors.affiliation: Department of Otolaryngology, New York University Langone Medical Center, New York, New York 10016, USA. srickert@gmail.com
authors.forename: Scott M
authors.initials: SM
authors.lastname: Rickert
authors.forename: Lesley F
authors.initials: LF
authors.lastname: Childs
authors.forename: Bridget T
authors.initials: BT
authors.lastname: Carey
authors.forename: Thomas
authors.initials: T
authors.lastname: Murry
authors.forename: Lucian
authors.initials: L
authors.lastname: Sulica
mesh_terms: D004576:Electromyography; D006801:Humans; D011379:Prognosis; D014826:Vocal Cord Paralysis / Q000503:physiopathology*