title: Diagnostic and prognostic contribution of laryngeal electromyography in unilateral vocal-fold immobility in adults.
abstract: OBJECTIVE
  To study the diagnostic and prognostic contribution of laryngeal electromyography in unilateral vocal-fold immobility in adults.
  
  
  METHODS
  A retrospective study included patients with unilateral vocal-fold immobility undergoing laryngeal electromyography between 2007 and 2015. Neurogenic, normal or myogenic findings were compared to the clinical aspect. Prognosis for recovery was assessed from motor unit potentials on laryngeal electromyography, and compared to subsequent progress on laryngoscopy.
  
  
  RESULTS
  Sixty-three patients (mean age, 59 years) were initially included; 2 were subsequently excluded from analysis. Mean time from onset of immobility to laryngeal electromyography was 7 months. 85% of the 61 patients showed neurogenic findings, indicating neural lesion; 13% showed normal electromyography, indicating cricoarytenoid joint ankylosis; and 1 patient showed a myogenic pattern. Neurogenic cases were usually secondary to cervical surgery. Thirty-eight patients were followed up. In total, 75% of patients showing reinnervation potentials recovered. The positive predictive value of laryngeal electromyography was 69.2%.
  
  
  CONCLUSIONS
  Laryngeal electromyography is effective in specifying the origin of unilateral vocal-fold immobility in adults. It also has a prognostic role, lack of reinnervation potentials being a possible indication for early medialization surgery.
authors.affiliation: CHU de Nantes, Service d'ORL et Chirurgie Cervico-Faciale, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: A
authors.initials: A
authors.lastname: Focquet
authors.affiliation: CHU de Nantes, Service d'Explorations Fonctionnelles Neurologiques, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Péréon
authors.affiliation: CHU de Nantes, Service d'ORL et Chirurgie Cervico-Faciale, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: S
authors.initials: S
authors.lastname: Ségura
authors.affiliation: CHU de Nantes, Service d'ORL et Chirurgie Cervico-Faciale, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Ferron
authors.affiliation: CHU de Nantes, Service d'ORL et Chirurgie Cervico-Faciale, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: O
authors.initials: O
authors.lastname: Malard
authors.affiliation: CHU de Nantes, Service d'ORL et Chirurgie Cervico-Faciale, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France. Electronic address: florent.espitalier@chu-nantes.fr.
authors.forename: F
authors.initials: F
authors.lastname: Espitalier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001193:Arytenoid Cartilage / Q000503:physiopathology; D003413:Cricoid Cartilage / Q000503:physiopathology; D004576:Electromyography; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000294:innervation / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014826:Vocal Cord Paralysis / Q000175:diagnosis* / Q000503:physiopathology*; D055815:Young Adult
keywords: Cricoarytenoid joint ankylosis; Laryngeal electromyography; Motor unit potentials; Vocal-fold palsy