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Laryngeal electromyography and prognosis of unilateral vocal fold paralysis--a long-term prospective study.
Laryngoscope. 2015 Apr; 125(4):898-903.L

Abstract

OBJECTIVES/HYPOTHESIS

To confirm the value of using laryngeal electromyography (LEMG) to predict the long-term prognosis of unilateral vocal fold paralysis (UVFP), and elucidate the adequate timing of LEMG.

STUDY DESIGN

Prospective cohort prognosis study.

METHODS

The LEMG data of 84 patients with UVFP were prospectively collected, and 81 patients received follow-up at least 6 months after symptom onset. If the paralyzed vocal fold had <20% recruitment reduction during phonation compared to the normal vocal fold signals, and absence of fibrillation when the patient was silent, the prognosis was considered to be good (negative finding). Otherwise, the prognosis was considered to be poor (positive finding). The association between UVFP outcome and LEMG prognostic rules and the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of LEMG were calculated.

RESULTS

The mean duration of LEMG after symptom onset was 3.7 months, and follow-up after symptoms onset was 18.4 months. Sixty-six of 71 patients with a positive finding had persistent UVFP; four of 10 patients with a negative finding recovered vocal fold motion. LEMG results were significantly associated with the outcome of UVFP (P = .007). The overall accuracy, sensitivity, specificity, PPV, and NPV of LEMG were 86.4%, 91.7%, 44.4%, 93.0%, and 40.0%, respectively. When LEMG was done more than 2 months after symptom onset, the PPV was 97.9%.

CONCLUSIONS

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.

Authors+Show Affiliations

School of Medicine, National Yang-Ming University, Taipei, Taiwan; School of Speech Language Pathology & Audiology, Chung-Shan Medical University, Taichung, Taiwan; Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25346497

Citation

Wang, Chen-Chi, et al. "Laryngeal Electromyography and Prognosis of Unilateral Vocal Fold Paralysis--a Long-term Prospective Study." The Laryngoscope, vol. 125, no. 4, 2015, pp. 898-903.
Wang CC, Chang MH, De Virgilio A, et al. Laryngeal electromyography and prognosis of unilateral vocal fold paralysis--a long-term prospective study. Laryngoscope. 2015;125(4):898-903.
Wang, C. C., Chang, M. H., De Virgilio, A., Jiang, R. S., Lai, H. C., Wang, C. P., Wu, S. H., & Liu, S. A. (2015). Laryngeal electromyography and prognosis of unilateral vocal fold paralysis--a long-term prospective study. The Laryngoscope, 125(4), 898-903. https://doi.org/10.1002/lary.24980
Wang CC, et al. Laryngeal Electromyography and Prognosis of Unilateral Vocal Fold Paralysis--a Long-term Prospective Study. Laryngoscope. 2015;125(4):898-903. PubMed PMID: 25346497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laryngeal electromyography and prognosis of unilateral vocal fold paralysis--a long-term prospective study. AU - Wang,Chen-Chi, AU - Chang,Ming-Hong, AU - De Virgilio,Armando, AU - Jiang,Rong-San, AU - Lai,Hsiu-Chin, AU - Wang,Ching-Ping, AU - Wu,Shang-Heng, AU - Liu,Shih-An, Y1 - 2014/10/24/ PY - 2014/08/30/revised PY - 2014/09/29/accepted PY - 2014/10/28/entrez PY - 2014/10/28/pubmed PY - 2015/6/9/medline KW - Fibrillation KW - laryngeal electromyography KW - prognosis KW - recruitment reduction KW - vocal fold paralysis SP - 898 EP - 903 JF - The Laryngoscope JO - Laryngoscope VL - 125 IS - 4 N2 - OBJECTIVES/HYPOTHESIS: To confirm the value of using laryngeal electromyography (LEMG) to predict the long-term prognosis of unilateral vocal fold paralysis (UVFP), and elucidate the adequate timing of LEMG. STUDY DESIGN: Prospective cohort prognosis study. METHODS: The LEMG data of 84 patients with UVFP were prospectively collected, and 81 patients received follow-up at least 6 months after symptom onset. If the paralyzed vocal fold had <20% recruitment reduction during phonation compared to the normal vocal fold signals, and absence of fibrillation when the patient was silent, the prognosis was considered to be good (negative finding). Otherwise, the prognosis was considered to be poor (positive finding). The association between UVFP outcome and LEMG prognostic rules and the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of LEMG were calculated. RESULTS: The mean duration of LEMG after symptom onset was 3.7 months, and follow-up after symptoms onset was 18.4 months. Sixty-six of 71 patients with a positive finding had persistent UVFP; four of 10 patients with a negative finding recovered vocal fold motion. LEMG results were significantly associated with the outcome of UVFP (P = .007). The overall accuracy, sensitivity, specificity, PPV, and NPV of LEMG were 86.4%, 91.7%, 44.4%, 93.0%, and 40.0%, respectively. When LEMG was done more than 2 months after symptom onset, the PPV was 97.9%. CONCLUSIONS: 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. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/25346497/Laryngeal_electromyography_and_prognosis_of_unilateral_vocal_fold_paralysis__a_long_term_prospective_study_ L2 - https://doi.org/10.1002/lary.24980 DB - PRIME DP - Unbound Medicine ER -