Gül Ibrahim, Akbulut Sevtap, Sanlı Arif, Paksoy Mustafa, Inan Rahşan Adviye, Berk Derya
Department of Otolaryngology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, 34865 Kartal, Cevizli, İstanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2014 May-Jun;24(3):129-36. doi: 10.5606/kbbihtisas.2014.26428.
This study aims to identify patients with benign vocal cord lesions using laryngeal electromyography (EMG) and to investigate the presence of accompanying vocal cord paresis.
Twenty-eight patients (18 males and 10 females; mean age 38.6±10.2 years; range 22 to 59 years) who were diagnosed with benign vocal cord lesion using a rigid laryngostroboscopy underwent laryngeal EMG and the presence of neurogenic involvement was investigated.
Laryngostroboscopic examination revealed polyp in 85.7% (n=24), Reinke's edema in 10.7% (n=3), submucosal cyst in 10.7% (n=3), and contact granuloma in 3.6% (n=1). Of the patients, 14.2% (n=4) were suspected to have vocal cord paresis. Laryngeal EMG revealed neurogenic involvement in at least one of the larynx muscles in 57.2% (n=16) of the patients. Eight patients (28.6%) had unilateral neurogenic involvement, while three (10.7%) demonstrated isolated recurrent laryngeal nerve paresis two (7.2%) demonstrated isolated superior laryngeal nerve paresis, and three (10.7%) demonstrated combined recurrent and superior laryngeal nerve paresis. Six (21.4%) of eight patients with bilateral neurogenic involvement had paresis in three laryngeal nerves, whereas in two (7.2%) patients four laryngeal nerves were affected.
Our study shows that vocal cord paresis frequently accompanies benign vocal cord lesions. Laryngeal EMG is useful to identify clinically suspected or unsuspected paresis with physical examination precisely.
本研究旨在利用喉肌电图(EMG)识别患有良性声带病变的患者,并调查是否伴有声带麻痹。
28例经硬管喉镜检查诊断为良性声带病变的患者(18例男性,10例女性;平均年龄38.6±10.2岁;年龄范围22至59岁)接受了喉肌电图检查,并对神经源性受累情况进行了调查。
硬管喉镜检查显示,息肉占85.7%(n = 24),任克氏水肿占10.7%(n = 3),黏膜下囊肿占10.7%(n = 3),接触性肉芽肿占3.6%(n = 1)。其中,14.2%(n = 4)的患者疑似有声带麻痹。喉肌电图显示,57.2%(n = 16)的患者至少有一块喉肌存在神经源性受累。8例患者(28.6%)为单侧神经源性受累,3例(10.7%)表现为孤立性喉返神经麻痹,2例(7.2%)表现为孤立性喉上神经麻痹,3例(10.7%)表现为喉返神经和喉上神经联合麻痹。8例双侧神经源性受累患者中有6例(21.4%)三条喉神经出现麻痹,2例(7.2%)患者四条喉神经受累。
我们的研究表明,声带麻痹常伴有良性声带病变。喉肌电图有助于准确识别临床疑似或体检未发现的麻痹。