University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Otolaryngology - Head & Neck Surgery, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada.
Muscle Nerve. 2021 Jul;64(1):104-108. doi: 10.1002/mus.27262. Epub 2021 May 20.
INTRODUCTION/AIMS: Temporary vocal fold injection (VFI) is a common treatment for acute and subacute vocal fold paralysis (VFP). Laryngeal electromyography (LEMG) is useful for diagnosing neurogenic causes of VFP. This study evaluated whether the presence of VFI material prevents interpretation of LEMG in patients with acute and subacute VFP.
Patients with acute and subacute unilateral VFP (onset ≤6 mo) who underwent temporary VFI within 3 mo preceding LEMG were evaluated. A matched control group that did not undergo VFI was also studied. The LEMG team (laryngologist and electromyographer) performed and interpreted LEMG using a pre-specified protocol, including qualitative and quantitative motor unit analysis.
Eighteen patients with VFI underwent LEMG successfully with interpretation of spontaneous activity and motor unit recruitment. Fourteen patients were seen in follow-up to determine accuracy of established LEMG prognosis. Seven of seven subjects with poor LEMG prognosis did not recover vocal fold motion. Five of seven subjects with fair LEMG prognosis recovered vocal fold motion. Findings were similar for the control group.
VFI augmentation material did not prevent interpretation of meaningful LEMG data in patients with acute and subacute VFP, and accurate prognoses of vocal fold motion recovery were established.
简介/目的:暂时性声带注射(VFI)是治疗急性和亚急性声带麻痹(VFP)的常用方法。喉肌电图(LEMG)有助于诊断 VFP 的神经源性病因。本研究评估了在急性和亚急性单侧 VFP(发病≤6 个月)患者中,VFI 材料是否会妨碍 LEMG 的解读。
评估了在 LEMG 前 3 个月内接受过暂时性 VFI 的急性和亚急性单侧 VFP(发病≤6 个月)患者。还研究了未接受 VFI 的匹配对照组。LEMG 团队(喉科医生和肌电图医生)按照预定方案进行并解读 LEMG,包括定性和定量运动单位分析。
18 例接受 VFI 的患者成功进行了 LEMG,可解读自发性活动和运动单位募集情况。14 例患者在随访中以确定已建立的 LEMG 预后的准确性。7 例 LEMG 预后差的患者均未恢复声带运动。5 例 LEMG 预后一般的患者恢复了声带运动。对照组的结果相似。
VFI 增强材料并未妨碍急性和亚急性 VFP 患者有意义的 LEMG 数据的解读,并能准确预测声带运动恢复情况。