Electromyographic Evaluation of Vocal Folds in Patients With Laryngeal Paralysis Referred for Injection Laryngoplasty

Paulina Krasnodębska; Beata Miaśkiewicz; Agata Szkiełkowska

doi:10.1016/j.jvoice.2023.06.010

Electromyographic Evaluation of Vocal Folds in Patients With Laryngeal Paralysis Referred for Injection Laryngoplasty

J Voice. 2023 Nov 15:S0892-1997(23)00185-6. doi: 10.1016/j.jvoice.2023.06.010. Online ahead of print.

Authors

Paulina Krasnodębska¹, Beata Miaśkiewicz², Agata Szkiełkowska¹

Affiliations

¹ Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
² Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland. Electronic address: b.miaskiewicz@ifps.org.pl.

PMID: 37977968
DOI: 10.1016/j.jvoice.2023.06.010

Abstract

Background: According to the literature, almost 80% of the patients diagnosed with permanent unilateral laryngeal paralysis experience vocal disability. Laryngeal electromyography (LEMG) provides information on the characteristics and progression of the disease process, allowing for optimal treatment. The aim of this study was to evaluate LEMG recordings in patients with unilateral vocal fold (VF) immobility referred for injection laryngoplasty (IL).

Material and methods: 17 patients with unilateral laryngeal immobilisation as an iatrogenic complication after neck surgery. The patients were referred for IL surgery due to glottic insufficiency. All patients underwent a preoperative otolaryngologic-phoniatric evaluation with perceptual and acoustic voice assessment and LEMG.

Results: Patients with unilateral VF immobilisation referred for injection laryngoplasty for glottal insufficiency show significant differences on LEMG between the mobile and immobile folds. In these patients, electromyography (EMG) features of the thyroarytenoid (TA) muscle correlate with the severity of breathiness in the voice and pathological variation in the fundamental frequency. Despite the lack of mobility and features of VF atrophy, only 12% meet the electromyographic criterion for vocal fold paralysis. The immobile VF has a poorer recording from the TA muscle, the more material needs to be injected to surgically model the glottis during IL.

Conclusions: This study demonstrated that LEMG is a valuable criterion for qualifying patients for injection laryngoplasty in unilateral vocal fold paralysis.

Keywords: Electromyography; LEMG; Laryngoplasty; Paralysis; Vocal fold.