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新冠病毒引起的喉感觉神经病:喉肌电图的发现。

Laryngeal sensory neuropathy caused by COVID-19: findings using laryngeal electromyography.

机构信息

Institute of Physiology and Pathology of Hearing, Warsaw, Poland.

出版信息

Eur Arch Otorhinolaryngol. 2023 Jul;280(7):3295-3302. doi: 10.1007/s00405-023-07895-0. Epub 2023 Mar 17.

Abstract

PURPOSE

Laryngeal sensory neuropathy (LSN) is caused by a disorder of the superior laryngeal nerve or the recurrent laryngeal nerve. A diagnosis of LSN should include laryngeal electromyography (LEMG) and laryngovideostroboscopy (LVS). The aim of this study was to characterize the physical and subjective symptoms of neuropathy in patients diagnosed with LSN following COVID-19.

MATERIAL AND METHODS

Since the beginning of the COVID-19 pandemic, 6 patients who had recovered from the disease presented to us with LSN symptoms. All patients underwent laryngological and phoniatric examination, objective and subjective voice assessment, and LEMG.

RESULTS

The most common LSN symptom reported by patients was periodic hoarseness of varying severity. Other common symptoms were the sensation of a foreign body in the throat and voice fatigue. Endoscopy often showed functional abnormalities. The LSN patients could be characterized by LEMG recordings, and all showed abnormal activity of the cricothyroid (CT) muscle. The degree of EMG changes in the CT correlated moderately with the severity of dysphonia.

CONCLUSIONS

Sensory neuropathy of the larynx may be a long-lasting complication of SARS-COV-2 infection. The severity of EMG neuropathic changes in the CT muscle broadly corresponds to the severity of dysphonia.

摘要

目的

喉感觉神经病变(LSN)是由喉上神经或喉返神经紊乱引起的。LSN 的诊断应包括喉肌电图(LEMG)和喉频闪喉镜检查(LVS)。本研究旨在描述 COVID-19 后诊断为 LSN 的患者的神经病变的物理和主观症状。

材料和方法

自 COVID-19 大流行开始以来,有 6 名已从疾病中康复的患者因 LSN 症状就诊。所有患者均接受了喉科学和语音学检查、客观和主观的声音评估以及 LEMG 检查。

结果

患者报告的最常见的 LSN 症状是周期性的不同严重程度的声音嘶哑。其他常见症状包括喉咙异物感和声音疲劳。内窥镜检查常显示功能异常。LSN 患者可通过 LEMG 记录来表征,并且所有患者的环甲肌(CT)均显示异常活动。CT 的肌电图变化程度与发音困难的严重程度中度相关。

结论

喉感觉神经病变可能是 SARS-COV-2 感染的长期并发症。CT 肌肉的 EMG 神经病变变化的严重程度与发音困难的严重程度大致对应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4772/10220104/e2d746e66883/405_2023_7895_Fig1_HTML.jpg

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