Laryngeal Electromyography in the Management of Vocal Cord Mobility Problems in Children
- 1 July 2002
- journal article
- research article
- Published by Wiley in The Laryngoscope
- Vol. 112 (7), 1243-1248
- https://doi.org/10.1097/00005537-200207000-00019
Abstract
Objectives To evaluate the efficacy and clinical usefulness of laryngeal electromyography (EMG) in the evaluation and management of vocal cord mobility problems in children; and to determine the ability of laryngeal EMG to differentiate vocal fold fixation versus paralysis. Study Design Case-series review of 8 children with vocal cord immobility who underwent laryngeal EMG. Methods Eight children with bilateral vocal fold immobility underwent microlaryngoscopy and electromyography. Bipolar concentric needle electrodes were used and implanted separately into both posterior cricoarytenoid (PCA) and both thyroarytenoid (TA) muscles. EMG activity was recorded during spontaneous ventilation under a light plane of anesthesia with propofol. EMG activity was correlated with the phases of the respiratory cycle. Results Three patients had evidence of normal EMG activity with PCA activity peaking during early inspiration. Maximal TA activity occurred expiration. These patients were assumed to have vocal fold fixation. Two of these 3 patients underwent laryngotracheoplasty (LTP) with posterior glottic expansion with costal cartilage. One is being considered for LTP in the future. Five patients had abnormal EMG activity and remain tracheotomy-dependent. Four patients exhibited synkinetic activity with peak PCA activity during expiration and peak TA activity during expiration. Two patients had both fixation and unilateral vocal cord paralysis. One was successfully decannulated after posterior graft LTP and the other is planned for the future. Conclusions Electromyography, which differentiates paralysis from fixation, is a useful diagnostic tool in the evaluation of children with vocal cord immobility.Keywords
This publication has 27 references indexed in Scilit:
- Comparison of concentric needle versus hooked-wire electrodes in the canine larynxOtolaryngology -- Head and Neck Surgery, 1998
- Vocal cord paralysis: Clinical and electrophysiologic featuresMuscle & Nerve, 1993
- The clinical differentiation between vocal cord paralysis and vocal cord fixation using electromyographyThe Laryngoscope, 1993
- The Problem of Pediatric Laryngotracheal StenosisThe Laryngoscope, 1991
- Vocal cord paralysis in children deborahThe Laryngoscope, 1990
- CO2 laser cordectomy for bilateral vocal-cord paralysisLasers in Medical Science, 1989
- Management of Chiari II complications in infants with myelomeningoceleThe Journal of Pediatrics, 1987
- Predictive value of laryngeal electromyography in patients with vocal cord paralysis of neurogenic originThe Laryngoscope, 1985
- Laser ArytenoidectomyJAMA Otolaryngology–Head & Neck Surgery, 1985
- Pediatric vocal cord paralysisThe Laryngoscope, 1979