Rodriquez A A, Ford C N, Bless D M, Harmon R L
University of Wisconsin-Madison Medical School 53792-3256.
Electromyogr Clin Neurophysiol. 1994 Oct-Nov;34(7):403-7.
Electromyographic (EMG) evidence of inappropriate muscle activity (IMA) in the cricothyroid (CT) and vocalis (V) (thyroarytenoid) muscles was correlated with clinical voice measures in 32 patients with spasmodic dysphonia (SD). Subjective voice rating and quantified fluency and laryngeal diadochokinesis measures were obtained prior to botulinum toxin (Botox) injection into the V muscles. Pre-Botox EMG was performed using a monopolar needle electrode. Each muscle was sequentially examined at rest, during vocal click, scale, sustained "E" at different pitches, and repeated "E" voicings for brief periods. A three point EMG severity scale was used to grade the amount of IMA seen in each muscle. EMG evaluation showed no evidence of lower motor neuron involvement but did reveal IMA in 81.3% of the subjects. There were no significant correlations for the patients between different EMG-based IMA severity scales and the measures of voice quality and sound production. EMG did discriminate between predominantly adductor and abductor SD pattern types, but could not correctly differentiate a mixed SD group. Those patients with adductor SD displayed IMA in the V and CT muscles, while those with abductor SD displayed more IMA in the CT than the V muscles. Sequential EMG assessment of CT and V IMA in SD did not predict clinical severity or outcome following Botox injection into the V muscles.
在32例痉挛性发声障碍（SD）患者中，环甲肌（CT）和声肌（V，即甲杓肌）不适当肌肉活动（IMA）的肌电图（EMG）证据与临床嗓音指标相关。在向V肌注射肉毒杆菌毒素（肉毒素）之前，获取主观嗓音评分、量化的流畅度和喉快速交替运动测量值。注射肉毒素前的EMG检查使用单极针电极。依次在静息状态、发声时发出咔哒声、唱音阶、不同音高持续发“E”音以及短时间重复发“E”音时检查每块肌肉。使用三点EMG严重程度量表对每块肌肉中观察到的IMA量进行分级。EMG评估未显示下运动神经元受累的证据，但确实在81.3%的受试者中发现了IMA。不同基于EMG的IMA严重程度量表与嗓音质量和发声测量值之间，患者并无显著相关性。EMG确实能区分主要为内收型和外展型的SD模式类型，但无法正确区分混合型SD组。内收型SD患者在V肌和CT肌中显示IMA，而外展型SD患者在CT肌中显示的IMA比V肌更多。对SD患者的CT肌和V肌IMA进行连续EMG评估，并不能预测向V肌注射肉毒素后的临床严重程度或结果。
