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[标准肌电图在喉神经肌肉疾病诊断及预后评估中的应用]

[Standard electromyography for the diagnosis and prognosis of laryngeal neuromuscular disorders].

作者信息

Canals Ruiz P, Villoslada Prieto C, López Catalá F, Peris Beaufils J L, Marco Peiro A, Marco Algarra J

机构信息

Servicio de ORL, Hospital de Sagunto.

出版信息

Acta Otorrinolaringol Esp. 1995 May-Jun;46(3):203-7.

PMID:7619556
Abstract

The clinical use of the laryngeal electromyography is still scanty; nevertheless, in our experience it has been shown to be an efficient and objective test in the study of the neurological disorders of the larynx and in the prognosis of recovery after vocal cord paralysis. We have performed conventional electromyography of the thyroarytenoid and cricothyroid muscles in 25 patients with laryngoscopically--confirmed vocal cord paralysis of different etiology. Positive sharp waves, fibrillation potentials and decreased or absent activity on maximal voluntary effort provided enough evidence of denervation in those cases of neurogenic origin. An increased number of polyphasic potentials and increased length of the motor unit potentials recruited in reduced interference patterns were considered suggestive of reinervation, which has an outstanding prognostic value on laryngeal neuropathy. Voluntary motor units, even in some clinically non-mobile vocal cords, were identified in recruitment patterns. Laryngeal electromyography can be done as an office procedure with a minimum of discomfort. It gives objective evaluation of the neuromuscular status, and shows direct evidence of cord function, being useful to distinguish from supranuclear and mechanical disorders of the larynx. It has also shown to be efficient as recovery predictor after vocal cord paralysis.

摘要

喉肌电图的临床应用仍然较少;然而,根据我们的经验,它已被证明是研究喉部神经疾病以及预测声带麻痹后恢复情况的一种有效且客观的检查方法。我们对25例经喉镜检查确诊为不同病因声带麻痹的患者进行了甲杓肌和环甲肌的常规肌电图检查。正锐波、纤颤电位以及最大自主用力时活动减弱或消失,为那些神经源性病例的失神经提供了足够的证据。在干扰图形减少时,多相电位数量增加以及募集的运动单位电位长度增加被认为提示有神经再支配,这对喉神经病变具有显著的预后价值。在募集图形中可识别出随意运动单位,即使在一些临床上声带不能活动的病例中也是如此。喉肌电图检查可在门诊进行,患者不适最小。它能对神经肌肉状态进行客观评估,并显示声带功能的直接证据,有助于区分喉部的核上性和机械性疾病。它也已被证明在预测声带麻痹后的恢复情况方面是有效的。

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