Electromyography in children's laryngeal mobility disorders: a proposed grading system.
OBJECTIVE
To describe a consecutive series of children with laryngeal mobility disorders assessed by laryngeal electromyography (LEMG), to propose a grading system for LEMG findings, and to determine whether the LEMG grades correlate with requirement for tracheostomy.


METHODS
Retrospective, observational, uncontrolled study.


METHODS
A single pediatric otolaryngology practice.


METHODS
Children who had LEMG performed and a minimum follow-up of 3 months.


METHODS
Demographic characteristics, diagnoses, surgical procedures, number of LEMG procedures, and complications were obtained. The LEMG results from the thyroarytenoid and posterior cricoarytenoid muscles were graded 0 to 4 according to amplitude and relation to the phase of respiration. A correlation analysis between the need for tracheostomy and the baseline LEMG score as well as a multivariable analysis to determine the predictors of requirement for tracheostomy were performed.


RESULTS
Between April 28, 2008, and November 2, 2011, 43 LEMG procedures were performed on 23 patients (13 girls; mean [SD] age, 1.5 [2.85] years). Eight required tracheostomy. Among the 23 patients, 16 had laryngeal paralysis (11 bilateral, 5 unilateral), 4 had laryngeal dyskinesia, and 3 had miscellaneous conditions. Fourteen had secondary large airway lesions, and 14 had a nonairway diagnosis that affected respiration. The overall LEMG results correlated negatively with requirement for tracheostomy (r = -0.4; P < .05) and were 86.36% accurate compared with endoscopy. No predictors for tracheostomy were identified.


CONCLUSIONS
The LEMG grading was accurate and correlated with the requirement for tracheostomy. Combined with endoscopy, the grading may help better characterize laryngeal mobility disorders.
Division of Pediatric Surgery, Pediatric Otolaryngology Service, Department of Surgery, Stollery Children’s Hospital and University of Alberta Hospital, Edmonton, Alberta, Canada.
Zeinab
Z
AlQudehy
Jonathan
J
Norton
Hamdy
H
El-Hakim
D002648:Child; D002675:Child, Preschool; D004576:Electromyography / Q000145:classification; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000503:physiopathology / Q000601:surgery; D007821:Laryngeal Muscles / Q000503:physiopathology; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014826:Vocal Cord Paralysis / Q000503:physiopathology