Role of Laryngeal Electromyography in Predicting Recovery After Vocal Fold Paralysis

Accurate prognostication of the outcome of vocal fold immobility assumes great importance in the management. This study aimed to evaluate the prognostic efficacy of Laryngeal electromyography in cases of vocal fold immobility. A nonrandomized prospective study was carried out from Sep 2009 to Jun 2011. Patients were evaluated using Fiberoptic laryngoscopy and Laryngeal electromyography over a period of 24 weeks. 51 subjects participated in the study, comprised of 22 males and 29 females. All patients underwent detailed clinical examination including Fiberoptic laryngoscopy on the first visit and Laryngeal electromyography testing on the second visit. Subsequent neuromonitoring was carried out at 04, 12 and 24 weeks from date of initial recording. Outcome measures of vocal fold motion were dichotomized into persistent vocal fold immobility (unilateral or bilateral) or resolved vocal fold motion (normal). Approximately 24 weeks after onset of palsy, mobility of the paralyzed vocal cord was restored in 31 (60.78 %) of 51 cases, while 20 (39.22 %) remained immobile. Sensitivity of laryngeal electromyography was 92.53 % ; specificity 93.33 %, positive predictive value 98.77 % and negative predictive value 68.29 %. This study confirmed the utility of Laryngeal electromyography in predicting prognosis for recovery of vocal fold motion after laryngeal nerve injury. The results supported the hypothesis that Laryngeal electromyography data can be used effectively to determine a prognosis for recovery of vocal fold motion.