Comparison of Clinical Characteristics Between Patients With Different Causes of Vocal Cord Immobility

Abstract

ObjectiveTo analyze the clinical characteristics between neurogenic and non-neurogenic cause of vocal cord immobility (VCI).MethodsThe researchers retrospectively reviewed clinical data of patients who underwent laryngeal electromyography (LEMG). LEMG was performed in the bilateral cricothyroid and thyroarytenoid muscles. A total of 137 patients were enrolled from 2011 to 2016, and they were assigned to either the neurogenic or non-neurogenic VCI group, according to the LEMG results. The clinical characteristics were compared between the two groups and a subgroup analysis was done in the neurogenic group.ResultsAmong the 137 subjects, 94 patients had nerve injury. There were no differences between the neurogenic and non-neurogenic group in terms of demographic data, underlying disease except cancer, and premorbid events. In general characteristics, cancer was significantly higher in the neurogenic group than non-neurogenic group (p=0.001). In the clinical findings, the impaired high pitched ‘e’ sound and aspiration symptoms were significantly higher in neurogenic group (p=0.039 for impaired high pitched ‘e’ sound; p=0.021 for aspiration symptoms), and sore throat was more common in the non-neurogenic group (p=0.014). In the subgroup analysis of neurogenic group, hoarseness was more common in recurrent laryngeal neuropathy group than superior laryngeal neuropathy group (p=0.018).ConclusionIn patients with suspected vocal cord palsy, impaired high pitched ‘e’ sound and aspiration symptoms were more common in group with neurogenic cause of VCI. Hoarseness was more frequent in subjects with recurrent laryngeal neuropathy. Thorough clinical evaluation and LEMG are important to differentiate underlying cause of VCI.

Investigation of Superior Laryngeal Nerve Disorders with Laryngeal Electromyography in Patients with Hoarseness

“…In another retrospective study in 137 patients, L-EMG results showed that SLN, recurrent laryngeal nerve or both were damaged in 94 patients, while 43 patients had normal findings. Twenty five percent of the neurogenic involvement has been reported to be idiopathic, while others have been reported after the treatment of thyroid, parathyroid, lung and pancreatic malignant tumors (9). In our study, we found that 12 of 14 patients with functional disorder and 4 of 10 patients with organic disorder had neurogenic involvement in L-EMG.…”

Effects of percutaneous injection laryngoplasty on voice and swallowing problems in cancer‐related unilateral vocal cord paralysis

“…To identify the neurogenic cause of laryngeal dysfunction and the severity of nerve injury, we performed pre‐treatment laryngeal electromyography. 9 Patients who refused laryngeal electromyography or were at a high risk of bleeding (platelet < 50 000 or INR > 3.0) or infection (absolute neutrophil count < 500) were not tested but were not excluded from the study. The result of the electromyography was used to help with patient counseling.…”

Cervical Hyperostosis Leading to Dyspnea, Aspiration and Dysphagia: Strategies to Improve Patient Management

“…Another possible reason could be an infection of the recurrent nerve itself ( 10 , 19 ). We could exclude this in our patient because the intraoperative electromyography of the vocal muscle on both sides showed normal action potentials ( 20 ).…”