2024 Workshop Handout Bundle-W08A EMG Laryngeal

W08A EMG Laryngeal - Munin

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The article "Utility of Laryngeal Electromyography for Establishing Prognosis and Individualized Treatment after Laryngeal Neuropathies" by Libby J. Smith and Michael C. Munin highlights the key role of laryngeal electromyography (LEMG) in diagnosing and managing neuropathic injuries affecting the recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN). These nerves control vocal fold (VF) motion critical for voice, swallowing, and breathing. Neuropathies affecting VF motion can significantly impact quality of life and often result from surgeries to the skull base, neck, or chest.<br /><br />LEMG provides valuable insights by assessing the extent of nerve damage and predicting VF motion recovery. It characterizes laryngeal synkinesis, a condition involving misdirected nerve regrowth, which affects prognosis by assessing motor unit potential during specific maneuvers. This diagnostic tool integrates qualitative and quantitative data, aiding clinicians in formulating patient-centered treatment plans. These range from conservative measures such as watchful waiting to interventions like VF augmentation or reinnervation.<br /><br />The article explores the history, anatomy, and complex innervation of the larynx. It outlines the procedural steps for LEMG, emphasizing a team-based approach between electromyographers and otolaryngologists to improve accuracy and patient comfort during testing.<br /><br />Furthermore, the paper discusses LEMG's role in determining treatment strategies, including its predictive value on VF recovery and the influence of synkinesis on prognosis. It highlights that, despite some technical challenges, LEMG is crucial for timely intervention in patients suffering from laryngeal paralysis, offering them a personalized treatment pathway aimed at improving voice and swallowing functions. Future advancements could enhance the application of LEMG, including exploring treatments like nimodipine, which may aid nerve recovery.

Keywords

laryngeal electromyography

laryngeal neuropathies

vocal fold motion

nerve damage assessment

laryngeal synkinesis

patient-centered treatment

recurrent laryngeal nerve

superior laryngeal nerve

voice and swallowing

nerve recovery