일측성 성대 마비에서 운동단위 활동전위를 이용한 정량적 후두 근전도 분석
Quantitative Measurement of Laryngeal Electromyography Using Motor Unit Action Potential in Unilateral Vocal Cord Paralysis
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Background and Objectives：Laryngeal electromyography (LEMG) is valuable to evaluate the innervation status of the laryngeal muscles and the prognosis of vocal fold paralysis (VFP). However, there is a lack of agreement on quantitative interpretation of LEMG. The aim of this study is to measure the motor unit action potentials (MUAP) quantitatively in order to find cut-off values of amplitude, duration, phase for unilateral vocal fold paralysis patients. Materials and Method：Retrospective chart review was performed for the unilateral VFP patients who underwent LEMG from March 2016 to May 2018. Patient’s demography, cause of VFP, vocal cord mobility, and LEMG finding were analyzed. The difference between normal and paralyzed vocal folds and cut-off values of duration, amplitude, and phase in MUAP were evaluated. Results：Thirty-six patients were enrolled in this study. Paralyzed vocal fold had significantly longer duration (p=0.021), lower amplitude (p=0.000), and smaller phase (p=0.012) than the normal. The cut-off values of duration, amplitude, and phase in MUAP for unilateral VFP were 5.15 ms, 68.35 μV, and 1.85 respectively. Conclusion：An analysis of MUAP successfully provided quantitative differences between normal and paralyzed vocal folds. But, additional research is needed to get more available cut-off value which is helpful to evaluate the status of laryngeal innervations.
Abstract
Background and Objectives：Laryngeal electromyography (LEMG) is valuable to evaluate the innervation status of the laryngeal muscles and the prognosis of vocal fold paralysis (VFP). However, there is a lack of agreement on quantitative interpretation of LEMG. The aim of this study is to measure the motor unit action potentials (MUAP) quantitatively in order to find cut-off values of amplitude, duration, phase for unilateral vocal fold paralysis patients. Materials and Method：Retrospective chart review was performed for the unilateral VFP patients who underwent LEMG from March 2016 to May 2018. Patient’s demography, cause of VFP, vocal cord mobility, and LEMG finding were analyzed. The difference between normal and paralyzed vocal folds and cut-off values of duration, amplitude, and phase in MUAP were evaluated. Results：Thirty-six patients were enrolled in this study. Paralyzed vocal fold had significantly longer duration (p=0.021), lower amplitude (p=0.000), and smaller phase (p=0.012) than the normal. The cut-off values of duration, amplitude, and phase in MUAP for unilateral VFP were 5.15 ms, 68.35 μV, and 1.85 respectively. Conclusion：An analysis of MUAP successfully provided quantitative differences between normal and paralyzed vocal folds. But, additional research is needed to get more available cut-off value which is helpful to evaluate the status of laryngeal innervations.
참고문헌 (19)
- Sataloff RT, "Laryngeal electromyography : clinical application", Otolaryngol Clin North Am, 24(2), pp.228~234 (2010)
- Munin MC, "Consensus statement : Using laryngeal electromyography for the diagnosis and treatment of vocal cord paralysis", Muscle Nerve, 53(6), pp.850~855 (2016)
- Chung SM, "Laryngeal electromyography", J Korean Soc Laryngol Phoniatr Logop, 17(1), pp.5~13 (2006)
- Focquet A, "Diagnostic and prognostic contribution of laryngeal electromyography in unilateral vocal-fold immobility in adults", Eur Ann Otorhinolaryngol Head Neck Dis, 134(1), pp.13~18 (2017)
- Kimaid PA, "Laryngeal Electromyography Techniques and Clinical Use", J Clin Neurophysiol, 32(4), pp.274~283 (2015)
- Blitzer A, "Recommendations of the Neurolaryngology Study Group on laryngeal electromyography", Otolaryngol Head Neck Surg, 140(6), pp.782~793 (2009)
- Gavazzoni FB, "The clinical value of laryngeal electromyography in laryngeal immobility", J Clin Neurosci, 18(4), pp.524~527 (2011)
- Kimaid PA, "Laryngeal electromyography in normal Brazilian population", Electromyogr Clin Neurophysiol, 44(4), pp.243~245 (2004)
- Feinberg J, "EMG : myths and facts", HSS J, 2(1), pp.19~21 (2006)
- 문광하, "성대마비 예후판단을 위한 후두 근전도 간섭파형의 신뢰도 평가", 대한이비인후-두경부외과학회지, 61(3), pp.143~147 (2018), 대한이비인후과학회[DOI]
- Paniello RC, "Recurrent laryngeal nerve recovery patterns assessed by serial electromyography", Laryngoscope, 126(3), pp.651~656 (2016)
- Statham MM, "Quantitative laryngeal electromyography : turns and amplitude analysis", Laryngoscope, 120(10), pp.2036~2041 (2010)
- Smith LJ, "Quantitative electromyography improves prediction in vocal fold paralysis", Laryngoscope, 122(4), pp.854~859 (2012)
- Smith LJ, "Vocal fold motion outcome based on excellent prognosis with laryngeal electromyography", Laryngoscope, 126(10), pp.2310~2314 (2016)
- Statham MM, "Electromyographic laryngeal synkinesis alters prognosis in vocal fold paralysis", Laryngoscope, 120(2), pp.285~290 (2010)
- Dumitru D, "Physiologic basis of potentials recorded in electromyography", Muscle Nerve, 23(11), pp.1667~1685 (2000)
- Blitzer A, "Semon’s law revisited : an electromyographic analysis of laryngeal synkinesis", Ann Otol Rhinol Laryngol, 105(10), pp.764~769 (1996)
- Koivu MK, "Multi-MUP analysis of laryngeal muscles", Clin Neurophysiol, 113(7), pp.1077~1081 (2002)
- Lovelace RE, "Neurologic disorders of larynx", pp.66~81 (1992), Thieme Medical Publishings