L'Heveder G, Tea S H, Jezequel J, Mabin D
Service d'explorations fonctionnelles neurologiques, CHU Morvan, Brest, France.
Neurophysiol Clin. 1996;26(2):109-14. doi: 10.1016/0987-7053(96)83151-0.
Diagnosis of recurrent laryngeal nerve palsy is usually possible through a clinical, laryngoscopical and electromyographical approach, but at a critical stage of the nerve injury. We observed four cases of benign thyroïd tumoral processes with a preoperative electromyographic examination showing neurogenic abnormalities in the thyroarytenoid muscle without any clinical symptoms. We presume that only laryngeal electromyography permits the diagnosis of mild, even asymptomatic laryngeal recurrent nerve injury. A recurrent laryngeal nerve palsy occurs in thyroid tumors, most often in malignant conditions, rarely in benign ones. Nevertheless early forms of nerve injury with benign thyroïd pathology could be underrated. Since the functional prognosis of symptomatic laryngeal nerve palsy is doubtful, laryngeal electromyography, through its ability to diagnose early nerve injury, provides helpful indications in thyroïd benign tumoral diseases for the therapeutic decision.
喉返神经麻痹的诊断通常可以通过临床、喉镜检查和肌电图检查来实现，但这是在神经损伤的关键阶段。我们观察了4例良性甲状腺肿瘤患者，术前肌电图检查显示甲杓肌存在神经源性异常，但无任何临床症状。我们推测，只有喉肌电图能够诊断轻度甚至无症状的喉返神经损伤。喉返神经麻痹发生于甲状腺肿瘤，最常见于恶性肿瘤，很少见于良性肿瘤。然而，甲状腺良性病变早期神经损伤形式可能被低估。由于有症状的喉返神经麻痹的功能预后存在疑问，喉肌电图通过其诊断早期神经损伤的能力，为甲状腺良性肿瘤疾病的治疗决策提供了有用的指征。
