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Title: |
Respiration-Related Laryngeal Electromyography in Children With Bilateral Vocal Fold Paralysis | ||||||||||||||||||
| Authors: | Robert G. Berkowitz, MD, FRACS; Monique M. Ryan, FRACP; Paul M. Pilowsky, MBBS, PhD | ||||||||||||||||||
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We present 2 case reports to demonstrate the relationship between laryngeal muscle activity and respiration in children
with bilateral vocal fold paralysis (BVFP) by simultaneous laryngeal electromyography (EMG) with recording of chest
wall movement and intercostal muscle EMG. Laryngeal EMG was performed together with recording of chest wall
movement in a 55-day-old girl who was undergoing tracheostomy for idiopathic congenital BVFP. Normal phasic activity
was observed, ie, the thyroarytenoid (TA) muscle was active during expiration and the posterior cricoarytenoid (PCA)
muscle during inspiration, suggesting a good prognosis for recovery. The child was decannulated at 11 months. Laryngeal
EMG together with recording of chest wall movement and intercostal EMG in a 5-year-old girl who was tracheostomydependent
following tracheoesophageal fistula repair due to BVFP showed phasic activity during expiration for both the
TA and PCA muscles, indicating aberrant regeneration of the PCA motor nerve. The timing of laryngeal muscle activity
with respiration in the assessment of pediatric congenital BVFP is essential to demonstrate the presence of normal
or abnormal medullary respiratory neuronal input to laryngeal motoneurons. In cases in which BVFP is due to recurrent
laryngeal nerve injury, respiration-related laryngeal EMG will identify aberrant regeneration. Laryngeal EMG should be
combined with intercostal muscle EMG in the evaluation of children with significant vocal fold dysfunction of either
central or peripheral origin. (Ann Otol Rhinol Laryngol 2009;118:791-795.) |
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| Keywords: | electromyography, larynx, synkinesis | ||||||||||||||||||
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