Diagnostic laryngeal electromyography: The Wake Forest experience 1995-1999

KOUFMAN, JAMES A. MD
POSTMA, GREGORY N. MD
WHANG, CHRIS S. MD
REES, CATHERINE J. BS
AMIN, MILAN R. MD
BELAFSKY, PETER C. MD, PhD
JOHNSON, PAUL E. MD
CONNOLLY, KIERAN M. MD
WALKER, FRANCIS O. MD

Winston-Salem, North Carolina, and Philadelphia, Pennsylvania
From the Center for Voice Disorders, Department of Otolaryngology (Drs Koufman, Postma, Whang, Belafsky, Johnson, Connolly and Ms Rees), and Department of Neurology (Dr Walker), Wake Forest University School of Medicine; and Department of Otolaryngology (Dr Amin), Hannemann University School of Medicine.

Reprint requests: James A. Koufman, MD, Center for Voice Disorders of Wake Forest University, Department of Otolaryngology, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1034; e-mail, [email protected].

0194-5998/2001/$35.00 + 0 23/1/115856

doi:10.1067/mhn.2001.115856

Otolaryngology - Head & Neck Surgery 124(6):p 603-606, June 2001.

BACKGROUND:

Laryngeal electromyography (LEMG) is a valuable diagnostic/prognostic test for patients with suspected laryngeal neuromuscular disorders.

OBJECTIVE:

To report our experience with diagnostic LEMG at the Center for Voice Disorders of Wake Forest University and to evaluate the impact of LEMG on clinical management.

METHODS:

Retrospective chart review of 415 patients who underwent diagnostic LEMG over a 5-year period (1995-1999).

RESULTS:

Of 415 studies, 83% (346 of 415) were abnormal, indicating a neuropathic process. LEMG results altered the diagnostic evaluation (eg, the type of radiographic imaging) in 11% (46 of 415) of the patients. Unexpected LEMG findings (eg, contralateral neuropathy) were found in 26% (107 of 415) of the patients, and LEMG results differentiated vocal fold paralysis from fixation in 12% (49 of 415). Finally, LEMG results altered the clinical management (eg, changed the timing and/or type of surgical procedure) in 40% (166 of 415) of the patients.

CONCLUSIONS:

LEMG is a valuable diagnostic test that aids the clinician in the diagnosis and management of laryngeal neuromuscular disorders. (Otolaryngol Head Neck Surg 2001;124:603-6.)