Safety of Laryngeal Electromyography and Repetitive Stimulation

Laryngeal Electromyography (LEMG) is a procedure used to assess electrical signals from laryngeal muscles. It is considered to be the gold standard test for examining vocal fold paresis/paralysis. Repetitive stimulation studies, which usually are performed at the time of LEMG, can aid in assessment of neuromuscular function. Electromyography poses risks to the patient due to the use of electricity and needles. The purpose of this paper was to evaluate the safety of LEMG and discuss the possible complications.

This was a retrospective review of patients from January 2015 through February 2022. Information from patient charts included age, sex, chief complaint, past medical history, family medical history, medications, social history, strobovideolaryngoscopy results, type of paresis, professional voice user status, presence of pacemaker, laryngeal electromyography and repetitive stimulation study results, and reported complications. Complications were considered to be anything that differed from the norm. Pain was included as a complication. Data were analyzed for relationships and significance.

Five hundred patients were included. Eighteen of the 500 (3.6%) experienced complications. Four (2.1%) males and 14 (4.5%) females experienced complications. Nine of the 18 (50%) reported pain after the procedure, 1 (5.56%) had excessive bleeding (controlled with pressure), 5 (27.78%) reported voice changes, and 3 (16.67%) experienced difficulty with completion of the procedure. No patients with pacemakers or patients taking anticoagulants had complications, but repetitive stimulation studies were not performed on patients with pacemakers.

LEMG and repetitive stimulation studies are safe and effective procedures to examine laryngeal muscles. Repetitive stimulation studies are not recommended for patients with pacemakers.