Laryngeal Asymmetry on Indirect Laryngoscopy in a Symptomatic Patient Should Be Evaluated With Electromyography

Isolated Paresis of Laryngeal Adduction: What Are the Laryngoscopic and Stroboscopic Findings?

“…Therefore, VLS findings are not specific and may include asymmetries in gross motion, glottal configuration, and mucosal wave formation during phonation . Furthermore, the distinction among neurological impairment, functional or behavioral disorder, and innocent laryngeal asymmetry on VLS is not straightforward …”

“…Paresis of the vocal fold is a poorly understood clinical entity. 11,12,15 It may result from incomplete paralysis of the vagus, superior, and inferior laryngeal nerves, 11,13,16 or paralysis of terminal branches to specific ILMs. [1][2][3][4] Findings on VLS depend on the degree of neurological impairment, the affected muscle or muscles, and the relative compensation from the unaffected muscles.…”

“…11,12 Furthermore, the distinction among neurological impairment, functional or behavioral disorder, and innocent laryngeal asymmetry on VLS is not straightforward. 4,9,12,13 For these reasons, the diagnosis of vocal fold paresis may be challenging and is often missed. 11,12,16,17 Characterizing VLS findings in selective paralysis of specific ILMs may help define subgroups of patients with paresis and help in the diagnostic dilemma.…”

Clinical Features and Surgical Outcomes Following Closed Reduction of Arytenoid Dislocation

“…2,4,6,10 Both disorders result in vocal fold immobility, so unless there is a strong clinical suspicion of cricoarytenoid joint trauma and/or EMG evidence of intact RLN function, arytenoid dislocation may not be considered as a probable diagnosis at initial presentation. Of note, arytenoid malrotation may also occur in the congenitally asymmetric larynx: 20 as such, this should be considered in the differential diagnosis.…”

Frame by Frame Analysis of Glottic Insufficiency Using Laryngovideostroboscopy

“…13 Many articles argue for the use of LEMG in the diagnosis of VF paresis, whereas at the same time, other articles purport that more work is needed to determine its role in management. 3,12,[14][15][16][17][18] Although it may afford more diagnostic accuracy than the clinical flexible laryngoscopic and LVS examination alone in the face of suspected VF paresis, LEMG is less available and arguably an extra step for most otolaryngologists in the routine treatment of suspected incomplete VF motion abnormalities. One could argue that LEMG offers little information toward a change in therapeutic decision making for many, except that it may add a confirmatory or unanticipated finding to a suspected pathology.…”