Phenotypic Characterization of Laryngospasm: The Utility of Laryngeal Neurophysiological Studies

Reyes Márquez Altemir; Carmen Górriz Gil; Virginia Matallama; Alberto Pérez de Vargas Martínez; José Ramón García-Berrocal

doi:10.1016/j.jvoice.2022.06.017

Phenotypic Characterization of Laryngospasm: The Utility of Laryngeal Neurophysiological Studies

J Voice. 2022 Aug 1:S0892-1997(22)00171-0. doi: 10.1016/j.jvoice.2022.06.017. Online ahead of print.

Authors

Reyes Márquez Altemir¹, Carmen Górriz Gil², Virginia Matallama³, Alberto Pérez de Vargas Martínez⁴, José Ramón García-Berrocal²

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery; Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain; Department of Otorhinolaryngology-Head and Neck Surgery. Hospital Universitario Sanitas La Moraleja. Madrid, Spain. Electronic address: rmarquezaltemir@gmail.com.
² Department of Otorhinolaryngology-Head and Neck Surgery; Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
³ Department of Gastroenterology Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
⁴ Department of Neurophysiology. Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.

PMID: 35927189
DOI: 10.1016/j.jvoice.2022.06.017

Abstract

Objective: To determine the existence of laryngeal neuropathy and the influence of gastroesophageal reflux in patients with episodic laryngospasm.

Study design: Single -center, observational study with prospective clinical collection.

Study setting: Prospective analysis of 18 Spanish patients with episodic laryngospasm in a Spanish Public Center collected by otolaryngologist. The recruitment dates were from January 2019 to December 2019.

Methods: Data collection of 18 patients with episodic laryngospasm. Clinical characteristics, laryngeal neurophysiological studies and reflux esophageal testing were analyzed.

Results: All patients have a trigger for the laryngospasms, being the most prevalent adopting the supine position (27.7%). EMG and ENG were pathological in 83.3 and 63.6 % respectively. Chronic bilateral denervation (increased amplitude and duration of potentials) with signs of reinnervation in the non-active chronic phase (large polyphasia), was the most prevalent finding. Evidence of gastroesophageal reflux either by pH meter, Gastroscopy or both was found in 38.8 % of patients.

Conclusions: Neurophysiological studies have confirmed the existence of laryngeal neuropathy in the majority of patients with laryngospasm. A substantial percentage of patients (38.8%) with laryngospasm had objective GERD and improved with PPIs. Laryngeal EMG and ENG can establish a more accurate diagnostic for episodic laryngospams and may supports treatment with neuromodulators.

Keywords: Electromyography (EMG); Electroneurography (ENG); Gastroesophageal reflux disease (GERD); Irritable laryngeal syndrome (ILS); Laryngopharyngeal reflux; Laryngospasm.