Imamura Rui, Marcelo Agatha M, Tsuji Domingos H
Postgraduate Program in Otorhinolaryngology.
Department of Otorhinolaryngology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Laryngoscope. 2019 Apr;129(4):919-925. doi: 10.1002/lary.27414. Epub 2018 Nov 25.
OBJECTIVES/HYPOTHESIS: This study aimed to describe the videolaryngostroboscopic (VLS) findings in a cohort of patients with isolated paresis of laryngeal adduction and identify predictive variables that may be related to voice recovery.
Chart review and VLS analysis of dysphonic patients diagnosed with isolated paresis of laryngeal adduction by laryngeal electromyography (LEMG).
Demographic, clinical, VLS, and LEMG findings were analyzed according to the outcome of dysphonia.
There were 17 patients, 12 males (70.6%), mean age of 46.6 years, with median dysphonia duration of 4 months (range, 1-60 months) included in the study. In all patients, gross movement of both vocal folds were normal. Laryngoscopy showed limited adduction of the ipsilateral ventricular fold, contralateral interarytenoid region deviation, and vocal fold atrophy in 100%, 94.1%, and 76.5% of patients, respectively. VLS findings included: impairment of glottic closure (94.1%), phase asymmetry (94.1%), and reduced mucosal wave on the affected side (76.5%). Predictors of good voice outcome were sudden onset (P = .012), duration of dysphonia on presentation shorter than 5 months (P = .005), and absence of polyphasic potentials on LEMG (P = .041).
Findings on VLS as described suggest isolated paresis of laryngeal adduction and should warrant indication of LEMG for definite diagnosis. Voice improvement may be related to clinical and LEMG findings.
4 Laryngoscope, 129:919-925, 2019.
目的/假设：本研究旨在描述一组孤立性喉内收肌麻痹患者的视频喉动态镜（VLS）检查结果，并确定可能与声音恢复相关的预测变量。
对经喉肌电图（LEMG）诊断为孤立性喉内收肌麻痹的发音障碍患者进行病历回顾和VLS分析。
根据发音障碍的结果分析人口统计学、临床、VLS和LEMG检查结果。
本研究纳入了17例患者，其中男性12例（70.6%），平均年龄46.6岁，发音障碍持续时间中位数为4个月（范围1 - 60个月）。所有患者双侧声带的大体运动均正常。喉镜检查显示，分别有100%、94.1%和76.5%的患者同侧室襞内收受限、对侧杓间区偏移和声带萎缩。VLS检查结果包括：声门闭合障碍（94.1%）、相位不对称（94.1%）以及患侧黏膜波减弱（76.5%）。声音恢复良好的预测因素为起病突然（P = 0.012）、就诊时发音障碍持续时间短于5个月（P = 0.005）以及LEMG检查无多相电位（P = 0.041）。
所述VLS检查结果提示为孤立性喉内收肌麻痹，应行LEMG检查以明确诊断。声音改善可能与临床及LEMG检查结果有关。
4 喉镜，129:919 - 925，2019年。
