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Updated: Jul 5, 2026
Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
Prognostic indicators of unilateral vocal fold paralysis
Chen-Chi Wang1, Ming-Hong Chang, Ching-Ping Wang
1School of Medicine, National Defense Medical Center, and Department of Medicine, Chung-Shan Medical University, Taichung, Taiwan. ccwang@vghtc.gov.tw
Objectives:
To determine the possible prognostic indicators of unilateral vocal fold paralysis (UVFP) and survey the timing and values of preset laryngeal electromyography (LEMG) rules for UVFP.
Design:
Cohort study with retrospective data analysis.
Setting:
Voice clinic of a tertiary medical center.
Patients:
Complete data for 45 patients diagnosed with idiopathic or iatrogenic UVFP. The LEMG was performed between 3 weeks and 6 months from the onset of symptoms.
Main Outcome Measure:
At least 6 months after symptom onset and 3 months after LEMG.
Results:
Thirteen subjects showed resolved vocal fold motion (29%), and 32 had persistent vocal fold paralysis (71%). According to the LEMG decision rules proposed by Munin et al in 2003, the predictive values for positive results, negative results, sensitivity, specificity, and accuracy of LEMG were 78.9%, 71.4%, 93.8%, 38.5%, and 77.8%, respectively. We found the false-positive rate to be as high as 50% if LEMG was performed less than 2 months after symptom onset, and only 7.7% if LEMG was performed at least 2 months after symptom onset. After excluding 14 LEMG data recorded at less than 2 months, the predictive values for positive results, negative results, sensitivity, specificity, and accuracy of LEMG were 92.3%, 60%, 92.3%, 60.0%, and 87.1%, respectively. The predictive values of positive results and accuracy significantly improved without compromising sensitivity.
Conclusion:
This study confirms that LEMG is a clinically useful tool that can offer prognostic information for UVFP especially if it is done at least 2 months after symptom onset.
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