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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Article info
Publication history
Published online: December 21, 2020
Accepted:
November 19,
2020
Footnotes
This study was funded by Natural Science Foundation of Beijing (7172051) and Beijing Municipal Administration of Hospitals’ Youth Programme (QML20170201).
This study was presented orally at the 13th International Conference on Advances in Quantitative Laryngology, Voice and Speech Research (AQL), Montreal, Canada, June 2-4, 2019.
The authors have no funding, financial relationships, or conflicts of interest to disclose. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
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Copyright
© 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
