title: Consensus statement: Using laryngeal electromyography for the diagnosis and treatment of vocal cord paralysis.
abstract: The purpose of this study was to develop an evidence-based consensus statement regarding use of laryngeal electromyography (LEMG) for diagnosis and treatment of vocal fold paralysis after recurrent laryngeal neuropathy (RLN).
  
  
  
  Two questions regarding LEMG were analyzed: (1) Does LEMG predict recovery in patients with acute unilateral or bilateral vocal fold paralysis? (2) Do LEMG findings change clinical management in these individuals? A systematic review was performed using American Academy of Neurology criteria for rating of diagnostic accuracy.
  
  
  
  Active voluntary motor unit potential recruitment and presence of polyphasic motor unit potentials within the first 6 months after lesion onset predicted recovery. Positive sharp waves and/or fibrillation potentials did not predict outcome. The presence of electrical synkinesis may decrease the likelihood of recovery, based on 1 published study. LEMG altered clinical management by changing the initial diagnosis from RLN in 48% of cases. Cricoarytenoid fixation and superior laryngeal neuropathy were the most common other diagnoses observed.
  
  
  
  If prognostic information is required in a patient with vocal fold paralysis that is more than 4 weeks and less than 6 months in duration, then LEMG should be performed. LEMG may be performed to clarify treatment decisions for vocal fold immobility that is presumed to be caused by RLN. Muscle Nerve 53: 850-855, 2016.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Munin
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.|Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA.
authors.forename: Yolanda D
authors.initials: YD
authors.lastname: Heman-Ackah
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Clark A
authors.initials: CA
authors.lastname: Rosen
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Lucian
authors.initials: L
authors.lastname: Sulica
authors.affiliation: Ear, Nose and Throat Institute, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Maronian
authors.affiliation: Department of Neurology, Hofstra North Shore LIJ School of Medicine, Hempstead, New York, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Mandel
authors.affiliation: Department of Neurology, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Bridget T
authors.initials: BT
authors.lastname: Carey
authors.affiliation: Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Earl
authors.initials: E
authors.lastname: Craig
authors.affiliation: Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Gronseth
mesh_terms: D032921:Consensus; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004576:Electromyography / Q000379:methods*; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D006801:Humans; D007830:Larynx / Q000503:physiopathology*; D008297:Male; D011237:Predictive Value of Tests; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014827:Vocal Cords / Q000503:physiopathology
keywords: laryngeal electromyography; laryngeal muscles; larynx; recurrent laryngeal neuropathy; synkinesis; vocal fold paralysis