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The Causes and Laryngeal Electromyography Characteristics of Unilateral Vocal Fold Paralysis

  • Rong Hu
    Affiliations
    Department of Otorhinolaryngology-Head Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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  • Wen Xu
    Correspondence
    Address correspondence and reprint requests to Wen Xu, Department of Otorhinolaryngology-Head Neck Surgery, Beijing Tongren Hospital, 1 Dongjiaominxiang, Beijing 100730, China.
    Affiliations
    Department of Otorhinolaryngology-Head Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
    Search for articles by this author
  • Liyu Cheng
    Affiliations
    Department of Otorhinolaryngology-Head Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Published:December 21, 2020DOI:https://doi.org/10.1016/j.jvoice.2020.11.022

      Summary

      Objective

      To investigate the causes and laryngeal electromyography (LEMG) characteristics of unilateral vocal fold paralysis (UVFP).

      Methods

      We retrospectively analyzed the history and LEMG of 337 patients with unilateral vocal fold immobility. The etiology was reviewed and the characteristics of LEMG (including spontaneous potential, recruitment potential, evoked potential, synkinesia, and et al.) were analyzed.

      Results

      The causes included injury (177 cases, 52.5%), idiopathic causes (72 cases, 21.4%), infection (61 cases, 18.1%), tumor and compressive factors (27 cases, 8.0%). Among the injury group, 161 cases were caused by surgery (111 cases of thyroid surgery), and 16 cases were caused by trauma. LEMG showed that complete nerve injury was present in 72.9% of the injury group, 66.7% of the tumors or compressive factors group, 49.2% of the infection group, and 44.4% of the idiopathic group. Of the 337 patients, 136 patients (40.4%) had synkinesia in the posterior cricoarytenoid muscles, and only two of these patients also had synkinesia in the thyroarytenoid muscles. The proportion of complete recurrent laryngeal nerve (RLN) injury in patients with synkinesia was higher than that of patients without synkinesia.

      Conclusion

      The main cause of vocal fold paralysis is neck surgery, most commonly thyroid surgery. Patients with different causes of paralysis had different severities of RLN injury. LEMG showed that surgery or trauma accounted for the highest proportion of complete nerve injury. Patients with severe RLN injury were more prone to synkinesia, and the posterior cricoarytenoid muscles were more likely to have synkinesia than the thyroarytenoid muscles.

      Key words

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