Department of Otolaryngology, New York University Langone Medical Center, New York, New York 10016, USA.
Laryngoscope. 2012 Jan;122(1):158-61. doi: 10.1002/lary.22354. Epub 2011 Dec 6.
OBJECTIVES/HYPOTHESIS: To analyze existing evidence regarding utility of laryngeal electromyography (LEMG) for prognosis in cases of vocal fold palsy (VFP).
Meta-analysis of studies reporting LEMG results and clinical outcomes in 503 patients with of VFP identified by literature search.
Studies were identified by literature search. Method of diagnosis, interval to LEMG, criteria for prognostication, and outcome were assessed. Criteria for prognosis were standardized to the extent possible across all studies, and studies were checked for consistency in outcome measures and assessments. Pooled data were subjected to statistical analysis.
A total of 296/503 patients (58.8%) had findings predictive with poor prognosis, whereas 207/503 (41.2%) had findings of recovery. According to laryngoscopic examination, 269/296 patients with predicted poor recovery had poor recovery (positive predictive value=90.9%), whereas 27/296 (9.1%) had good recovery. In patients with findings consistent with recovery, 115/207 (negative predictive value=55.6%) noted return of motion, whereas 88/207 (44.4%) did not. The odds ratio was 11.56 with 95% confidence interval of 7.10-18.81.
LEMG is a good predictor of poor recovery in patients with VFP and is clinically useful in identifying candidates for early definitive intervention.
目的/假设：分析喉肌电图（LEMG）在评估声带麻痹（VFP）患者预后中的应用价值的现有证据。
通过文献检索，对 503 例 VFP 患者的 LEMG 结果和临床结局进行荟萃分析。
通过文献检索确定研究，评估诊断方法、LEMG 检查间隔、预后判断标准和结局。尽可能对所有研究的预后判断标准进行标准化，并检查研究结果的评估是否一致。对汇总数据进行统计学分析。
296/503 例（58.8%）患者的 LEMG 检查结果预测预后不良，207/503 例（41.2%）患者的检查结果预测有恢复可能。根据喉镜检查，269/296 例预测恢复不良的患者确实恢复不良（阳性预测值=90.9%），27/296 例（9.1%）患者恢复良好。在预测有恢复可能的患者中，207/207 例（100%）中有 115 例（55.6%）患者的运动功能恢复，207/207 例（100%）中有 88 例（44.4%）患者的运动功能未恢复。比值比为 11.56，95%置信区间为 7.10-18.81。
LEMG 是 VFP 患者预后不良的良好预测指标，有助于临床识别早期行确定性干预的候选患者。
