Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025
Spontaneous Activity in Laryngeal Electromyography for Prognosis Prediction for Unilateral Vocal Fold Paralysis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Tseng Jang-Jier, Chung Wei-Li, Lu Yi-An, Fang Tuan-Jen, Pei Yu-Cheng
Аннотация
OBJECTIVE: This study aims to examine the prognostic significance of spontaneous activity (SA) detected by laryngeal electromyography (LEMG) in patients with unilateral vocal fold paralysis (UVFP).
STUDY DESIGN: A prospective observational cohort study.
SETTING: A tertiary medical center.
METHODS: We enrolled 124 patients with UVFP who underwent initial LEMG within 6 months of symptom onset and a second LEMG evaluation at follow-up. SA in the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex was categorized as present (SA+; n = 87) or absent (SA-; n = 37). Outcome measures included LEMG parameters (peak turn frequency and turn ratio), glottal gap, acoustic voice analysis, and quality of life.
RESULTS: At baseline, SA+ patients exhibited significantly more decreased recruitment and lower peak turn frequency in the TA-LCA muscle complex compared to SA- patients. By follow-up, only the difference in decreased recruitment remained significant. SA+ was also associated with lower maximum phonation time at baseline; however, no significant group differences were observed in glottal gap, acoustic voice measures, or quality of life at follow-up. SA independently predicted decreased recruitment over the long term, aligning with prior observations that SA is often accompanied by recruitment deficits during the subacute to chronic phases post-denervation.
CONCLUSION: Although SA independently predicted the presence of decreased recruitment at long-term follow-up, it lacked predictive value for quantitative LEMG peak turn frequency. Therefore, SA should be evaluated alongside recruitment patterns to provide a more comprehensive prognosis for UVFP. This study offers a more nuanced view of the prognostic role of SA, thereby enhancing the predictive accuracy of LEMG in patients with UVFP.
STUDY DESIGN: A prospective observational cohort study.
SETTING: A tertiary medical center.
METHODS: We enrolled 124 patients with UVFP who underwent initial LEMG within 6 months of symptom onset and a second LEMG evaluation at follow-up. SA in the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex was categorized as present (SA+; n = 87) or absent (SA-; n = 37). Outcome measures included LEMG parameters (peak turn frequency and turn ratio), glottal gap, acoustic voice analysis, and quality of life.
RESULTS: At baseline, SA+ patients exhibited significantly more decreased recruitment and lower peak turn frequency in the TA-LCA muscle complex compared to SA- patients. By follow-up, only the difference in decreased recruitment remained significant. SA+ was also associated with lower maximum phonation time at baseline; however, no significant group differences were observed in glottal gap, acoustic voice measures, or quality of life at follow-up. SA independently predicted decreased recruitment over the long term, aligning with prior observations that SA is often accompanied by recruitment deficits during the subacute to chronic phases post-denervation.
CONCLUSION: Although SA independently predicted the presence of decreased recruitment at long-term follow-up, it lacked predictive value for quantitative LEMG peak turn frequency. Therefore, SA should be evaluated alongside recruitment patterns to provide a more comprehensive prognosis for UVFP. This study offers a more nuanced view of the prognostic role of SA, thereby enhancing the predictive accuracy of LEMG in patients with UVFP.