Current opinion on laryngeal electromyography

Rosa Delia Ramírez Ruiz; Mariam Quintillá; Marta Sandoval; Lucía León; Jose Miguel Costa; Miquel Quer

doi:10.1016/j.otoeng.2023.07.001

Current opinion on laryngeal electromyography

Acta Otorrinolaringol Esp (Engl Ed). 2023 Oct 30:S2173-5735(23)00096-0. doi: 10.1016/j.otoeng.2023.07.001. Online ahead of print.

Authors

Rosa Delia Ramírez Ruiz¹, Mariam Quintillá², Marta Sandoval³, Lucía León², Jose Miguel Costa³, Miquel Quer⁴

Affiliations

¹ Department of Otolaryngology, HospitalClínico, Barcelona, Spain. Electronic address: rdramirez@clinic.cat.
² Department of Neurology, Hospital Moisès Broggi de Sant Joan Despí, Barcelona, Spain.
³ Department of Otolaryngology, HospitalClínico, Barcelona, Spain.
⁴ Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain.

PMID: 37913988
DOI: 10.1016/j.otoeng.2023.07.001

Abstract

Purpose: This study evaluates expert opinion on laryngeal electromyography (LEMG).

Methods: A cross-sectional design was used to conduct an online survey of LEMG experts in 2021. They were questioned about the number LEMG performed annually, type of electrodes used, sector worked in, pain during the test, placement of the needle electrodes, interpretation of electrical muscle parameters, diagnosis of neuromuscular injury, prognostic sensitivity in vocal fold paralysis (VFP), laryngeal dystonia, tremor and synkinesis and quantifying LEMG.

Results: Thirty-seven professionals answered (23 Spanish and 14 from other countries), with a response rate of 21.56%. All physicians used LEMG. 91.9% had one- or two-years' experience and 56.8% performed 10-40 LEMG per year. 70.3% were otolaryngologists and 27%, neurologists. In 89.1% of cases, a team of electrodiagnostic physician and otolaryngologist performed LEMG. 91.3% of Spanish respondents worked in Public Health, 7.14% of other nationalities; 37.8% in a university department. Bipolar concentric needles electrodes were used by 45.9% and monopolar concentric by 40.5%. 57% professionals considered good patients' tolerance to the test. LEMG sensitivity was regarded as strong, median and interquartile range were 80.0 [60.0;90.0] to diagnose peripheral nerve injuries, less for other levels of lesions, and strong to evaluate prognosis, 70.0 [50.0;80.0]. Respondents believe locate the thyroarytenoid and the cricothyroid muscles with the needle, 80.0 [70.0;90.0], as opposed to 20.0 [0.00;60.0] the posterior cricoarytenoid. The interpretation of the electrical parts of the LEMG was strong, 80.0 [60.0;90.0]. LEMG identify movements disorders, 60.0 [20.0;80.0], and synkinesis, 70.0 [30.0;80.0]. The professionals prefer quantitative LEMG, 90.0 [60.0;90.0].

Conclusions: The experts surveyed consider LEMG that is well tolerated by patients. The insertional and spontaneous activity, recruitment and waveform morphology can be assessed easily. LEMG is mainly useful in the study of peripheral nerve injuries, and its value in VFP prognosis is considered strong.

Keywords: Electromiografía cuantitativa; Electromiografía laríngea; Encuesta; Inmovilidad de las cuerdas vocales; Laryngeal electromyography; Movimiento de las cuerdas vocales; Paresia de las cuerdas vocales; Parálisis de las cuerdas vocales; Quantitative electromyography; Sincinesia; Survey; Synkinesis; Vocal fold immobility; Vocal fold motion; Vocal fold paralysis; Vocal fold paresis.