喉麻痹患者喉肌电图结果的观察

Laryngoelectromyography for the diagnosis of unilateral laryngeal paralysis

目的探索喉肌电图检查在单侧喉麻痹诊断中的应用价值。方法回顾性研究18例单侧喉麻痹者的喉肌电检查结果及其它临床资料,分析患侧喉肌电募集模式、是否有失神经及神经再生电位以及甲杓肌、环杓后肌的电活动是否存在正常相位等参数特征,并与健侧相关参数进行比较。结果18例患者患侧喉肌电均有异常改变,主要表现为1～3个被检喉内肌肌电募集减弱。其中,甲杓肌肌电募集减弱现象见于所有病例;14例(77.8%)检测到失神经电位,均未发现神经再生电位;2例患者出现外展性联动。全部患者健侧喉肌电图均表现正常。结论喉肌电图可以为单侧喉麻痹的定性和定位诊断提供重要信息。本病喉肌电图的主要改变是受累喉内肌肌电募集减弱,多数伴有失神经电位,部分患者可出现喉内肌联动。

Objective To investigate the efficacy of laryngoelectromyography（LEMG） for the diagnosis of unilateral laryngeal paralysis based on a clinical trial. Methods A retrospective study was carried out among 18 cases with unilateral laryngeal paralysis treated in our Hospital during 2007, with their lesion diagnosed by a clinical diagnostic program at first and followed by systematic laryngoelectromyography to confirm the clinical diagnosis then. This study was performed on the basis of looking into the laryngoelectromyographic features in a comparative way with that recorded from healthy side of laryngeal muscles among themselves. The parameters of laryngoelectromyogram carefully studied here included the patterns of recruitment, presence or absence of denervated or reinnervated potentials, as well as the active phase of potentials from thyroarythenoid and posterior cricoarytenoid muscles, supplemented by a comparative analysis on these parameters with that of the contra-lateral laryngeal muscles recorded in the same way for each case. Results Abnormal changes in the parameters of LEMG could be observed among all these 18 cases with such a condition, with the characteristic changes being reduced recruitment potentials in one to three laryngeal muscles. Among them, such a reduced recruitment potential recorded from thyroarythenoid muscle could be found among all these studied cases. Denervated potentials were recorded in 14 cases （77.8%）, while no re-innervated ones found, and 2 cases were observed with a LEMG showing the phenomena of abductor synkinesia. In contrast, wholly normal LEMG was recorded from the healthy side of laryngeal muscles. Conclusions Laryngoelectromyography can provide very important information for the qualitative and focus-determining diagnosis of unilateral laryngeal paralysis. This kind of lesion commonly manifests itself as reduced recruitment potentials from the involved laryngeal muscles recorded on the laryngoelectromyogram, possibly companying with denervated potentials and the phenomena of adductor or abductor synkinesia.