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Laryngeal electromyography – a review of guidelines and current literature

Paulina Krasnodębska1, Agata Szkiełkowska1,2

Affiliation and address for correspondence
Aktualn Neurol 2020, 20 (1), p. 32–38
DOI: 10.15557/AN.2020.0005
Abstract

The aim of this paper was to present current guidelines on the analysis and interpretation of laryngeal electromyography (LEMG) along with a review of the main trends in the use of EMG in otolaryngology and phoniatric practice. Current guidelines were developed by the American Academy of Otolaryngology – Head and Neck Surgery in 2009 and by the European Laryngological Society in 2012. Both scientific societies postulate adaptation and inclusion of LEMG in standard clinical practice in ENT departments. The activities of the European Laryngological Society for the development of LEMG resulted in the implementation of regular training workshops (since 2014) and the creation of www.lemg.org website for those interested in laryngeal neurophysiology. The standards for the interpretation of electromyographic recordings include identification and description of such patterns as insertional activity, spontaneous activity, fibrillations, positive sharp waves, polyphasia, fasciculations, and repetitive discharges. Motor unit recruitment pattern is assessed during phonatory and non-phonatory tasks. Literature analysis indicates that there are four main areas of LEMG application in otolaryngology and phoniatric practice. These include an assessment of vocal fold motion disorder, evaluation of the physiology of the laryngeal muscles, intraoperative monitoring of laryngeal nerves and monitoring of laryngeal muscle activity using surface electromyography. Scientific communities emphasise the importance of LEMG as a component of otolaryngological and phoniatric diagnostic standards and make efforts to expand the use of LEMG. The authors of current recommendations encourage the continuous development of the method. The perspective of further development assumes the search for appropriate objectifying parameters and a change of the guidelines, which are currently limited to qualitative assessment of LEMG findings.

Keywords
laryngeal electromyography, dysphonia, vocal fold paralysis, dysphagia

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