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Laryngeal Electromyography as a Predictive Factor in the Evolution of Unilateral Recurrent Paralysis Post-Thyroidectomy

Title: Laryngeal Electromyography as a Predictive Factor in the Evolution of Unilateral Recurrent Paralysis Post-Thyroidectomy
Authors: Shirley Tarabichi; Codrut Sarafoleanu
Source: Journal of Clinical Medicine ; Volume 14 ; Issue 4 ; Pages: 1047
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: laryngeal electromyography; dysphonia; thyroidectomy; vocal fold paresis; laryngeal recurrent nerve; recovery; prognosis
Description: Background: Dysphonia, a common symptom after thyroid surgery, is most often caused by damage to the recurrent laryngeal nerve. Laryngeal electromyography (LEMG) is used as a qualitative diagnostic tool to distinguish neurological etiology from other causes of dysphonia. The purpose of this study is to establish the value of LEMG as a predictor factor in the recovery of unilateral recurrent paralysis post-thyroidectomy. Methods: This study included 11 patients with unilateral vocal fold palsy (UVFP) evidenced on the videostrobolaryngoscopy (VSL) after thyroidectomy. Electrical activity of thyroarytenoid (TA) muscles of the patients included in the study was recorded through LEMG and the prognosis of the lesions was classified as excellent, fair, or poor based on the presence of spontaneous activity and motor unit recruitment. Results: LEMG at the first clinic visit showed an excellent prognosis in three of the cases, a fair prognosis in three of the cases, and five of them indicated a poor prognosis. At 6 months after the first LEMG, patients with a poor prognosis were unchanged and showed no LEMG improvement. Those with an excellent prognosis showed an increased recruitment response, and LEMG was normal. In one patient with a fair prognosis and minimal spontaneous activity, LEMG recruitment decreased during reevaluation. The other two fair-prognosis patients had a normal LEMG. Conclusions: A correlation was found between LEMG findings and functional recovery of the vocal cords, demonstrating that the presence of spontaneous activity represents a negative prognostic factor. However, due to limited patient cohorts, the sensitivity of the LEMG as a prognostic tool in the functional recovery of the larynx is not yet established and requires further research.
Document Type: text
File Description: application/pdf
Language: English
Relation: Otolaryngology; https://dx.doi.org/10.3390/jcm14041047
DOI: 10.3390/jcm14041047
Availability: https://doi.org/10.3390/jcm14041047
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.100E19DA
Database: BASE