Simpson C Blake, May Linda Seitan, Green Jill K, Eller Robert L, Jackson Carlayne E
Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center-San Antonio, 78229, USA.
Ann Otol Rhinol Laryngol. 2011 Apr;120(4):239-42. doi: 10.1177/000348941112000404.
The purpose of this study was to determine whether the videostroboscopic finding of vibratory asymmetry in mobile vocal folds is a reliable predictor of vocal fold paresis. In addition, the ability of experienced reviewers to predict the distribution (left/right/bilateral) of the paresis was investigated.
This is a retrospective chart review of all patients who presented to our clinic during a 3-year period with symptoms suggestive of glottal insufficiency (vocal fatigue or reduced vocal projection) accompanied by the videostroboscopic findings of bilateral normal vocal fold mobility and vibratory asymmetry. Twenty-three of these patients underwent diagnostic laryngeal electromyography of the thyroarytenoid and cricothyroid muscles to determine the presence of vocal fold paresis.
Nineteen of the 23 patients (82.6%) were found to have electrophysiological evidence of vocal fold paresis, either unilaterally or bilaterally, when videostroboscopic asymmetry was present in mobile vocal folds. However, the three expert reviewers' ability to predict the distribution (left/right/bilateral) of the paresis was poor (26.3%, 36.8%, and 36.8%, respectively).
The videostroboscopic finding of vibratory asymmetry in mobile vocal folds is a reliable predictor of vocal fold paresis in most cases. However, the ability of expert reviewers to determine the distribution (left/right/bilateral) of the paresis using videostroboscopic findings is poor. This study highlights the value of laryngeal electromyography in arriving at a correct diagnosis in this clinical situation.
本研究旨在确定动态声带振动不对称的频闪喉镜检查结果是否为声带麻痹的可靠预测指标。此外，还研究了经验丰富的评估者预测麻痹分布（左侧/右侧/双侧）的能力。
这是一项回顾性图表审查研究，研究对象为在3年期间到我们诊所就诊、有声门功能不全症状（声音疲劳或声音投射减弱）且频闪喉镜检查显示双侧声带动态正常但振动不对称的所有患者。其中23例患者接受了甲状杓肌和环甲肌的诊断性喉肌电图检查，以确定是否存在声带麻痹。
当动态声带存在频闪喉镜检查不对称时，23例患者中有19例（82.6%）被发现有单侧或双侧声带麻痹的电生理证据。然而，三位专家评估者预测麻痹分布（左侧/右侧/双侧）的能力较差（分别为26.3%、36.8%和36.8%）。
动态声带振动不对称的频闪喉镜检查结果在大多数情况下是声带麻痹的可靠预测指标。然而，专家评估者利用频闪喉镜检查结果确定麻痹分布（左侧/右侧/双侧）的能力较差。本研究强调了喉肌电图在这种临床情况下做出正确诊断的价值。
