Akbulut Sevtap, Inan Rahsan Adviye, Altintas Hande, Gul Ibrahim, Berk Derya, Paksoy Mustafa
Department of Otolaryngology Head and Neck Surgery, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Semsi Denizer Cad. E-5 Cevizli Mevkii, Kartal, 34890, Istanbul, Turkey,
Eur Arch Otorhinolaryngol. 2015 Jan;272(1):149-57. doi: 10.1007/s00405-014-3227-8. Epub 2014 Aug 20.
The aim of this study was to evaluate patients with vocal fold polyps using laryngeal electromyography (LEMG) for the presence of vocal fold paresis and to compare transnasal fiberoptic and rigid stroboscopic findings between polyp patients with normal LEMG and with vocal fold paresis. Thirty-five patients with a vocal fold polyp underwent transnasal fiberoptic laryngoscopy, rigid laryngostroboscopy, and LEMG. The findings were compared between the LEMG-confirmed vocal fold paresis patients and the normal LEMG patients. LEMG resulted in a diagnosis of unilateral or bilateral vocal fold paresis in 17 of 35 patients (48.6 %). More men than women with vocal fold polyps had vocal fold paresis (p < 0.05). The vocal fold paresis group had higher presence of axial rotation and hypomobility of vocal folds, higher asymmetry of vertical height of vocal folds, and less presence of longitudinal stretch of vocal folds (p < 0.05). Medial-lateral compression of the false vocal folds and anterior-posterior approximation of the larynx did not show any difference between the groups. No significant difference was found in vibratory wave characteristics between the groups through rigid laryngostroboscopy. Vocal fold paresis was present in almost half of the patients with vocal fold polyps. Paresis can only be accurately diagnosed with LEMG. Transnasal fiberoptic laryngoscopic examination is helpful to recognize vocal fold paresis in vocal fold polyp patients, while stroboscopic examination is not useful to identify it in vocal fold polyp patients.
本研究的目的是使用喉肌电图（LEMG）评估声带息肉患者是否存在声带麻痹，并比较LEMG正常和存在声带麻痹的息肉患者经鼻纤维喉镜和硬性频闪喉镜检查的结果。35例声带息肉患者接受了经鼻纤维喉镜检查、硬性喉镜频闪检查和LEMG检查。对LEMG确诊的声带麻痹患者和LEMG正常的患者的检查结果进行比较。LEMG检查诊断出35例患者中有17例（48.6%）存在单侧或双侧声带麻痹。声带息肉患者中，男性声带麻痹的发生率高于女性（p<0.05）。声带麻痹组声带轴向旋转和活动度降低的情况更多，声带垂直高度的不对称性更高，声带纵向伸展的情况更少（p<0.05）。两组间假声带的内外侧压缩和喉部的前后靠拢情况无差异。通过硬性喉镜频闪检查，两组间振动波特征无显著差异。声带息肉患者中近半数存在声带麻痹。只有通过LEMG才能准确诊断麻痹。经鼻纤维喉镜检查有助于识别声带息肉患者中的声带麻痹，而频闪喉镜检查对识别声带息肉患者中的声带麻痹并无帮助。
