title: Intraoperative laryngeal electromyography in children with vocal fold immobility: results of a multicenter longitudinal study.
abstract: OBJECTIVE
  To determine whether laryngeal electromyography (LEMG) can predict recurrent laryngeal nerve function return in children and whether LEMG can aid in the management of vocal fold immobility (VFI).
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Tertiary pediatric aerodigestive centers.
  
  
  METHODS
  Twenty-five children aged 14 days to 7 years at the time of first LEMG (mean age, 21.4 months) with VFI who underwent flexible fiberoptic laryngeal examination, intraoperative LEMG of the thyroarytenoid muscles, and 12-month follow-up.
  
  
  METHODS
  To compare results of LEMG with flexible fiberoptic laryngeal examination in children with vocal fold paresis and to determine if LEMG can predict vocal fold return.
  
  
  RESULTS
  In children who had a patent ductus arteriosus ligation, the LEMG data suggest that if there is no activity 6 months after injury, then the nerve is unlikely to regain function. In 3 of 3 children with central causes of VFI, normal LEMG findings predicted return of nerve function 2 to 7 months before vocal fold movement on fiberoptic examination. Finally, in 3 of 3 children with idiopathic VFI, LEMG predicted return within 2 to 14 months of vocal folds with normal findings.
  
  
  CONCLUSIONS
  Intraoperative LEMG is a safe, easy-to-use method for determining the likelihood of recurrent laryngeal nerve function return in children who have undergone patent ductus arteriosus ligation, in children with centrally correctable lesions, and in children with idiopathic VFI. More work is needed in the area of pediatric LEMG, but it is possible that LEMG data can be used to aid in management strategies and provide families with more information to make better informed decisions regarding their child's care.
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles St., Boston, MA 02114, USA.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Maturo
authors.forename: Nicole
authors.initials: N
authors.lastname: Braun
authors.forename: David J
authors.initials: DJ
authors.lastname: Brown
authors.forename: Peter Siao Tick
authors.initials: PS
authors.lastname: Chong
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kerschner
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hartnick
mesh_terms: D001927:Brain Diseases / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000601:surgery; D004576:Electromyography / Q000379:methods*; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007821:Laryngeal Muscles / Q000294:innervation; D007828:Laryngoscopy; D008137:Longitudinal Studies; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology; D014138:Tracheoesophageal Fistula / Q000601:surgery; D014826:Vocal Cord Paralysis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology