Laryngeal electromyography and prognosis of unilateral vocal fold paralysis—A long‐term prospective study

Wang, Chen‐Chi; Chang, Ming-Hong; Virgilio, Armando De; Jiang, Rong–San; Lai, Hsiu-Chin; Wu, Shang‐Heng; Liu, Shih–An

doi:10.1002/lary.24980

Cited by 42 publications

(36 citation statements)

References 21 publications

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“…In this context, Wang et al recently showed that laryngeal electromyography had a predictive positive value for permanent RLN injury of 93%. [11] Patients with the above-associated factors could be good candidates to laryngeal electromyography in order to perform a surgical treatment more rapidly if the test were positive.…”

Section: Discussionmentioning

confidence: 99%

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Recurrent laryngeal nerve injury after thyroid and parathyroid surgery

Joliat¹,

Guarnero²,

Demartines³

et al. 2017

Medicine

131

104

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Recurrent laryngeal nerve (RLN) injury is a feared complication after thyroid and parathyroid surgery. It induces important postoperative morbidity. The present study aimed to assess the incidence of transient/permanent postoperative RLN injuries after thyroid and parathyroid surgery in the present cohort, to observe the timing of recovery, and to identify risk factors for permanent RLN injury after thyroidectomy.All consecutive patients operated on at our institution for thyroid and parathyroid pathologies from 2005 to 2013 were reviewed for vocal cord paresis. Vocal cord paresis was defined based on postoperative fiberoptic laryngoscopy. Demographics, intraoperative details, and postoperative outcomes were collected. Treatment types were assessed, and recovery times collected. Patients with vocal cord paresis on preoperative fiberoptic laryngoscopy were excluded from the analysis.The cohort included 451 thyroidectomies (756 nerves at risk) and 197 parathyroidectomies (276 nerves at risk). There were 63 postoperative vocal cord pareses after thyroidectomy and 13 after parathyroidectomy. Sixty-nine were transient (10.6%) and 7 permanent (1.1%). The main performed treatment was speech therapy in 51% (39/76) of the patients. Median recovery time after transient injuries was 8 weeks. In the group with vocal cord paresis, risk factors for permanent injuries after thyroidectomy were previous thyroidectomy and intraoperative RLN injury on univariate analysis. On multivariate analysis, only intraoperative RLN injury remained significant.Most of the patients with transient postoperative RLN injury recovered normal vocal cord mobility within 6 months. The most common performed treatment was in this cohort speech therapy. Permanent RLN injuries remained rare (1.1%).

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Section: Discussionmentioning

confidence: 99%

“…[2] Only a few studies in the literature found risk factors for intraoperative RLN injury such as reoperation for bleeding or Graves disease. [11–13] …”

Section: Introductionmentioning

confidence: 99%

Recurrent laryngeal nerve injury after thyroid and parathyroid surgery

Joliat¹,

Guarnero²,

Demartines³

et al. 2017

Medicine

131

104

View full text Add to dashboard Cite

show abstract

“…Indeed, the prognostic value of LEMG in laryngeal paralysis has been reported in several studies . Two studies reported that the predictive value for definitive defective healing after axonal regeneration and for complete recovery after neurapraxia, estimated by initial LEMG, was 80% to 97% and 60% to 66%, respectively .…”

Section: Discussionmentioning

confidence: 93%

“…[9][10][11][12][13][14][15][16][17] Two studies reported that the predictive value for definitive defective healing after axonal regeneration and for complete recovery after neurapraxia, estimated by initial LEMG, was 80% to 97% and 60% to 66%, respectively. 9,10 In other studies, the LEMG showed a high predictive value in laryngeal paralysis patients with both poor 12,17 and excellent prognosis. 14 On the contrary, Sittel et al reported that the predictive value for complete recovery after neurapraxia, estimated by initial LEMG, was 13%.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of congenital idiopathic abductor laryngeal paralysis with laryngeal electromyography

Giotakis

Pototschnig

2019

The Laryngoscope

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Objective To assess if laryngeal electromyography could provide additional information in the prognosis of congenital bilateral idiopathic abductor vocal cord paralysis (abCBILP). Methods We performed a retrospective review over a 23‐year period (1995–2018) of all children younger than 13 years old in the Medical University of Innsbruck. Results We identified five infants with abCBILP. Fiberoptic laryngeal endoscopy revealed bilateral vocal cord immobility in adduction without accompanying laryngeal findings. Tracheostomy rate was 100%. Tracheostomy was performed after minimum 3 weeks of non‐improvement with continuous positive airway pressure treatment or intubation. In all patients, repeated laryngeal electromyography revealed volitional activity. All patients showed excellent full late recovery in the second quinquennium of life. Conclusion Presence of volitional activity in laryngeal electromyography could identify patients with excellent prognosis. Prospective laryngeal electromyography studies are required in more patients with abCBILP in order to document laryngeal electromyography findings also by patients with poor late recovery. Patients with poor prognosis could be selected for early laryngeal intervention to avoid tracheostomy‐dependent issues. Level of Evidence 4 Laryngoscope, 130:E252–E257, 2020

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“…Ez a magyarázata annak, hogy a hangszalagbénulás endoscopos képekkel látható végkifejlete nem mindig felel meg a LEMG során feltételezett prognózisnak. A metaanalízisek szerint tehát a LEMG nagy biztonsággal képes meghatározni a reinnerváció kedvezőtlen kimenetelét, azonban a potenciálisan kedvező LEMG-jelek ellenére a klinikailag észlelt reinnerváció nem egyértelmű a lehetséges synkineticus folyamatok kialakulása miatt [4,8,[29][30][31][32].…”

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A laryngealis electromyographia szerepe a hangszalag-mozgászavarok diagnosztikájában és az alkalmazott kezelés kiválasztásában

et al. 2018

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The development of the therapeutic possibilities of vocal cord immobility necessitated the parallel renewal of diagnostic methods. In the last years, laryngeal electromyography, which was first introduced more than 70 years ago, has been re-discovered. After reviewing the international literature and their own experience, the authors present the indications, technical requirements, method and, particularly, the evaluation of the results of this procedure. Laryngeal electromyography makes the differentiation between mechanical fixation and immobility with neurological origin of the vocal folds possible. In case of laryngeal paralysis/paresis it also evaluates objectively the severity of neural injury, the prognosis of the disease and the necessity of any glottis-widening procedure. The widespread application of dynamic rehabilitation interventions is not conceivable without the routine application of laryngeal electromyography, so this sensitive diagnostic tool has to be introduced in all laryngological centers. Orv Hetil. 2018; 159(8): 303-311.

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Laryngeal electromyography and prognosis of unilateral vocal fold paralysis—A long‐term prospective study

Abstract: LEMG has a high PPV in predicting the long-term outcome of UVFP patients with poor prognosis. Permanent laryngeal framework surgery is feasible if patients have positive findings at least 2 months after symptom onset.

Cited by 42 publications

References 21 publications

Recurrent laryngeal nerve injury after thyroid and parathyroid surgery

Recurrent laryngeal nerve injury after thyroid and parathyroid surgery

Prognosis of congenital idiopathic abductor laryngeal paralysis with laryngeal electromyography

A laryngealis electromyographia szerepe a hangszalag-mozgászavarok diagnosztikájában és az alkalmazott kezelés kiválasztásában

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