Practice parameter: laryngeal electromyography (an evidence-based review)

This paper reports on an evidence-based review of laryngeal electromyography (EMG) as a technique for use in the diagnosis, prognosis, and treatment of laryngeal movement disorders, including the laryngeal dystonias, vocal fold paralysis, and other neurolaryngological disorders. The authors performe...

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Bibliographic Details
Published in:Journal of voice 2004-06, Vol.18 (2), p.261-274
Main Authors: Sataloff, Robert T, Mandel, Steven, Mann, Eric A, Ludlow, Christy L
Format: Article
Language:English
Subjects:
Botulinum toxin
Electromyography
Electromyography - methods
Evidence-Based Medicine
Humans
Laryngeal Diseases - diagnosis
Laryngeal Diseases - therapy
Laryngeal dystonias
Laryngeal movement disorders
Laryngeal Muscles - physiopathology
Larynx
Medical Disorders
Medical Treatment
Prognosis
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Summary:This paper reports on an evidence-based review of laryngeal electromyography (EMG) as a technique for use in the diagnosis, prognosis, and treatment of laryngeal movement disorders, including the laryngeal dystonias, vocal fold paralysis, and other neurolaryngological disorders. The authors performed a systematic review of the medical literature from 1944 through 2001 on the clinical application of EMG to laryngeal disorders. Thirty-three of the 584 articles met the predefined inclusion criteria. The evidence demonstrated that in a double-blind treatment trial of botulinum toxin versus saline, laryngeal EMG used to guide injections into the thyroarytenoid muscle in persons with adductor spasmodic dysphonia was beneficial. A cross-over comparison between laryngeal EMG-guided injection and endoscopic injection of botulinum toxin into the posterior cricoarytenoid muscle in abductor spasmodic dysphonia found no significant difference between the two techniques and no significant treatment benefit. Based on the evidence, laryngeal EMG is possibly useful for the injection of botulinum toxin into the thyroarytenoid muscle in the treatment of adductor spasmodic dysphonia. There were no evidence-based data sufficient to support or refute the value of laryngeal EMG for the other uses investigated, although there is extensive anecdotal literature suggesting that it is useful for each of them. There is an urgent need for evidence-based research addressing other applications in the use of laryngeal EMG for other applications.
ISSN:0892-1997
1873-4588
DOI:10.1016/S0892-1997(03)00008-0