Читать книгу Advances in Neurolaryngology - Группа авторов - Страница 48

This chapter will focus on the advances in laryngeal electromyography (LEMG) in the last 5 years. Only clinical trials and no animal studies were considered. LEMG is in most cases an office-based procedure for decision making in neurolaryngology. Depending on the national regulations, LEMG is performed by an otolaryngologist or phoniatrician alone or in cooperation with an electrophysiologic physician. LEMG helps to differentiate abnormal function of the vocal folds from nonorganic disorders. It is mainly used to confirm the diagnosis of vocal fold paralysis (VFP) to prognosticate the outcome of VFP, and less frequently used for the diagnosis of myopathies and motor neuron disorders. On the road of standardization of LEMG, first consensus recommendations for standard performance of LEMG have been published. After many years with LEMG focus on the thyroarytenoid muscle (TA), more and more studies are performed including other important extrinsic and intrinsic laryngeal muscles, first of all the posterior cricoarytenoid muscle (PCA) and cricothyroid muscle (CT). Diagnostics and estimating the prognosis for patients with VFP remains the most important issue for LEMG. First meta-analyses are now available analyzing which LEMG parameters are the best prognosticators for recovery or persistent palsy. Reflecting the advances in multichannel LEMG including more and more muscles, laryngeal nerve monitoring studies are to a greater extent also including monitoring of the external branch of the superior laryngeal nerve. In addition, this chapter will also look at the role of LEMG for laryngeal pacing, guided laryngeal injections, laryngeal electrostimulation and explore indications beyond otolaryngology. The most important advances of LEMG are highlighted in Table 1.

Table 1. Most important advances of laryngeal electromyography (LEMG) in the last five years