Kim Min-Hyun, Noh Junsoo, Pyun Sung-Bom
Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, Korea.
Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Korea.
Ann Rehabil Med. 2017 Dec;41(6):1019-1027. doi: 10.5535/arm.2017.41.6.1019. Epub 2017 Dec 28.
To analyze the clinical characteristics between neurogenic and non-neurogenic cause of vocal cord immobility (VCI).
The researchers retrospectively reviewed clinical data of patients who underwent laryngeal electromyography (LEMG). LEMG was performed in the bilateral cricothyroid and thyroarytenoid muscles. A total of 137 patients were enrolled from 2011 to 2016, and they were assigned to either the neurogenic or non-neurogenic VCI group, according to the LEMG results. The clinical characteristics were compared between the two groups and a subgroup analysis was done in the neurogenic group.
Among the 137 subjects, 94 patients had nerve injury. There were no differences between the neurogenic and non-neurogenic group in terms of demographic data, underlying disease except cancer, and premorbid events. In general characteristics, cancer was significantly higher in the neurogenic group than non-neurogenic group (p=0.001). In the clinical findings, the impaired high pitched 'e' sound and aspiration symptoms were significantly higher in neurogenic group (p=0.039 for impaired high pitched 'e' sound; p=0.021 for aspiration symptoms), and sore throat was more common in the non-neurogenic group (p=0.014). In the subgroup analysis of neurogenic group, hoarseness was more common in recurrent laryngeal neuropathy group than superior laryngeal neuropathy group (p=0.018).
In patients with suspected vocal cord palsy, impaired high pitched 'e' sound and aspiration symptoms were more common in group with neurogenic cause of VCI. Hoarseness was more frequent in subjects with recurrent laryngeal neuropathy. Thorough clinical evaluation and LEMG are important to differentiate underlying cause of VCI.
分析声带麻痹（VCI）的神经源性和非神经源性病因的临床特征。
研究人员回顾性分析了接受喉肌电图（LEMG）检查的患者的临床资料。在双侧环甲肌和甲杓肌进行LEMG检查。2011年至2016年共纳入137例患者，根据LEMG结果将其分为神经源性或非神经源性VCI组。比较两组的临床特征，并对神经源性组进行亚组分析。
在137例受试者中，94例有神经损伤。神经源性组和非神经源性组在人口统计学数据、除癌症外的基础疾病和病前事件方面无差异。在一般特征方面，神经源性组的癌症发生率显著高于非神经源性组（p=0.001）。在临床检查结果中，神经源性组中高调“e”音受损和误吸症状明显更高（高调“e”音受损，p=0.039；误吸症状，p=0.021），而非神经源性组中咽痛更常见（p=0.014）。在神经源性组的亚组分析中，喉返神经病变组的声音嘶哑比喉上神经病变组更常见（p=0.018）。
在疑似声带麻痹的患者中，神经源性VCI病因组中高调“e”音受损和误吸症状更常见。喉返神经病变患者声音嘶哑更频繁。全面的临床评估和LEMG对于鉴别VCI的潜在病因很重要。
