Fang Tuan-Jen, Pei Yu-Cheng, Hsin Li-Jen, Lin Wan-Ni, Lee Li-Ang, Li Hsueh-Yu, Wong Alice M K
Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Laryngoscope. 2015 Nov;125(11):2530-5. doi: 10.1002/lary.25418. Epub 2015 Jun 24.
OBJECTIVES/HYPOTHESIS: Determination of superior laryngeal nerve (SLN) involvement in addition to recurrent laryngeal nerve (RLN) paralysis in patients with unilateral vocal fold paralysis (UVFP) relies on traditional, qualitative laryngeal electromyography (LEMG) examination. It is necessary to develop a quantitative measurement that reflects the degree of denervation of the cricothyroid (CT) muscle. The present study aimed to establish a standard quantitative assessment of CT function in patients with UVFP by measuring the turn frequency.
Case series study performed in an otolaryngology outpatient clinic.
Twenty healthy subjects and 103 patients with UVFP were recruited. The main outcome measures for the patients included acoustic analysis using traditional LEMG examination, quantitative LEMG analysis, and acoustic analysis based on fundamental frequency contours.
Acoustic reliability was examined in the healthy subjects, and the peak fundamental frequency in an upward glissando showed good test-retest reliability, especially for the offset fundamental frequency. LEMG indicated that 33 patients had RLN and SLN lesions (RLN+SLN group) and 70 had only RLN lesions (RLN group). When patients produced a standard upward glissando sound, the peak turn frequency reflecting the recruitment of the CT muscle was significantly lower in the RLN+SLN group compared with the RLN group (406±256 vs. 778±238 Hz; P<.001).
We conclude that quantitative measurement of the interference pattern when voicing a standard upward glissando sound may provide a feasible reflection of the degree of a SLN injury.
目的/假设：对于单侧声带麻痹（UVFP）患者，除了喉返神经（RLN）麻痹外，确定喉上神经（SLN）是否受累依赖于传统的定性喉肌电图（LEMG）检查。有必要开发一种能够反映环甲肌（CT）失神经程度的定量测量方法。本研究旨在通过测量转折频率建立UVFP患者CT功能的标准定量评估方法。
在耳鼻喉科门诊进行的病例系列研究。
招募了20名健康受试者和103例UVFP患者。患者的主要结局指标包括使用传统LEMG检查的声学分析、定量LEMG分析以及基于基频轮廓的声学分析。
在健康受试者中检查了声学可靠性，上行滑音中的基频峰值显示出良好的重测可靠性，尤其是对于基频偏移。LEMG显示，33例患者存在RLN和SLN病变（RLN+SLN组），70例仅存在RLN病变（RLN组）。当患者发出标准的上行滑音时，与RLN组相比，反映CT肌募集情况的峰值转折频率在RLN+SLN组中显著降低（406±256 vs. 778±238 Hz；P<.001）。
我们得出结论，发出标准上行滑音时干扰模式的定量测量可能为SLN损伤程度提供可行的反映。
4级。
