Electromyography of the Larynx
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Laryngeal electromyography (LEMG) has evolved over the past decades to become a clinical diagnostic tool for the neuro-laryngologist. Its primary uses are for (1) signal guidance for injection into the laryngeal muscle, (2) diagnostic needle LEMG, (3) diagnostic fine-wire LEMG, and, less commonly, (4) compound muscle action potential evaluation. Indeed, use for botulinum toxin injection may help improve accuracy and effectiveness of treatment. LEMG can help to distinguish the etiology of vocal fold motion impairment or help predict recovery in paralysis cases to inform earlier surgical management. Neurologic conditions such as spasmodic dysphonia can be more precisely characterized which may help to optimize treatment with botulinum toxin. This chapter aims to provide a summary of the key concepts in LEMG interpretation, as well as instruments and techniques that are essential to the neuro-laryngologist. Better understanding of the audio and visual cues will allow for better yield during use of this technique.
KeywordsNeurolaryngology Laryngeal electromyography Fine-wire electromyography Vocal fold motion impairment Vocal fold paralysis Botulinum toxin injection Spasmodic dysphonia Synkinesis
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