Vocal fold electromyography in patients with endoscopic features of unilateral laryngeal paralysis-Reference-Cited by-同舟云学术

Vocal fold electromyography in patients with endoscopic features of unilateral laryngeal paralysis

Published:2024-04-09 Issue:2 Volume:78 Page:18-22
ISSN:0030-6657
Container-title:Otolaryngologia Polska
language:
Short-container-title:Otolaryngol Pol

Author:

Krasnodębska Paulina¹^ORCID,Miaśkiewicz Beata¹^ORCID,Szkiełkowska Agata¹^ORCID,Skarżyński Henryk²^ORCID

Affiliation:

1. Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland

2. Otorhinolaryngology Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland

Abstract

Introduction: Electromyography (EMG) of the larynx provides information on the electrophysiological condition of laryngeal muscles and innervation. Integration of information obtained from the EMG exams with the clinical parameters as obtained by other methods for laryngeal assessment (endoscopy, perceptual and acoustic analysis, voice self-assessment) provides a multidimensional picture of dysphonia, which is of particular importance in patients with vocal fold (VF) mobility disorders accompanied by glottic insufficiency. Aim: The aim of this study was to evaluate laryngeal EMG records acquired in subjects with unilateral vocal fold immobilization with signs of atrophy and glottic insufficiency. Material and methods: From the available material of 74 EMG records of patients referred for the exam due to unilateral laryngeal paralysis, records of 17 patients with endoscopic features suggestive of complete laryngeal muscle denervation were selected. The EMG study of thyroarytenoid muscles of mobile and immobile VFs was evaluated qualitatively and quantitatively at rest and during volitional activity involving free phonation of vowel /e/ [ε]. Results: In all patients, the EMG records from mobile VFs were significantly different from those from immobile VFs. Despite endoscopic features of paralysis, no VF activity whatsoever was observed in as few as 2 patients so as to meet the neurophysiological definition of paralysis. In 88% of cases, electromyographic activity of the thyroarytenoid muscle was observed despite immobilization and atrophy of the vocal fold. In these patients, neurogenic type of record was observed with numerous high- -amplitude mobility units. On the basis of the results, quantitative features of EMG records indicative of paralysis and residual activity of the thyroarytenoid muscle were determined. Conclusions: Qualitative and quantitative analysis of laryngeal EMG records provides detailed information on the condition of vocal fold muscles and innervation. EMG records of mobile vs immobile VFs differ significantly from each other. Endoscopic evaluation does not provide sufficient basis for the diagnosis of complete laryngeal muscle denervation.

Publisher

Index Copernicus

Link

https://otolaryngologypl.com/gicid/pdf/01.3001.0053.8704

Reference13 articles.

1. Bendiksen F., Dahl H., Teig E.: Innervation pattern of different types of muscle fibres in the human thyroarytenoid muscle. Acta Otolaryngol., 1980;91(5–6): 391–397.

2. Buffelli M., Busetto G., Bidoia C., Favero M., Cangiano A.: Activity-dependentsynaptic competition at mammalian neuromuscular junctions. News PhysiolSci., 2004; 19(3): 85–91.

3. Krasnodębska P., Szkiełkowska A.: Laryngeal electromyography – a review ofguidelines and current literature. Aktualn Neurol., 2020; 20(1): 32–38.

4. Chen I., Remli R., Azman M. et al.: Quantitative laryngeal electromyography(LEMG) in unilateral vocal fold paralysis: Developing normative values using theopposite normal mobile vocal fold. Auris Nasus Larynx, 2021; 48(6): 1140–1149.

5. Szkiełkowska A., Krasnodębska P., Miaśkiewicz B.: Laryngeal electromyographyin laryngologic and phoniatric practice. Now Audiofonol, 2015; 4(4): 53–57.