Evaluation of benign vocal cord lesions with laryngeal electromyography

Yıl 2014, Cilt: 24 Sayı: 3, 129 - 136, 19.06.2014

İbrahim Gül Sevtap Akbulut Arif Şanlı H. Mustafa Paksoy Rahşan Adviye İnan Derya Berk

Öz

Objectives: This study aims to identify patients with benign vocal cord lesions using laryngeal electromyography EMG and to investigate the presence of accompanying vocal cord paresis. Patients and Methods: Twenty-eight patients 18 males and 10 females; mean age 38.6±10.2 years; range 22 to 59 years who were diagnosed with benign vocal cord lesion using a rigid laryngostroboscopy underwent laryngeal EMG and the presence of neurogenic involvement was investigated. Results: Laryngostroboscopic examination revealed polyp in 85.7% n=24 , Reinke's edema in 10.7% n=3 , submucosal cyst in 10.7% n=3 , and contact granuloma in 3.6% n=1 . Of the patients, 14.2% n=4 were suspected to have vocal cord paresis. Laryngeal EMG revealed neurogenic involvement in at least one of the larynx muscles in 57.2% n=16 of the patients. Eight patients 28.6% had unilateral neurogenic involvement, while three 10.7% demonstrated isolated recurrent laryngeal nerve paresis two 7.2% demonstrated isolated superior laryngeal nerve paresis, and three 10.7% demonstrated combined recurrent and superior laryngeal nerve paresis. Six 21.4% of eight patients with bilateral neurogenic involvement had paresis in three laryngeal nerves, whereas in two 7.2% patients four laryngeal nerves were affected. Conclusion: Our study shows that vocal cord paresis frequently accompanies benign vocal cord lesions. Laryngeal EMG is useful to identify clinically suspected or unsuspected paresis with physical examination precisely.

Anahtar Kelimeler

Benign vocal cord lesion, laryngeal electromyography, laryngostroboscopy, vocal cord paralysis, vocal cord paresis

Benign vokal kord lezyonlarının larengeal elektromiyografi ile değerlendirilmesi

Öz

Amaç: Bu çalışmada benign vokal kord lezyonu bulunan hastalar larengeal elektromiyografi ile EMG değerlendirildi ve eşlik eden vokal kord parezisi varlığı araştırıldı.Hastalar ve Yöntemler: Rijit larengostroboskop ile benign vokal kord lezyonu saptanan 28 hastaya 18 erkek, 10 kadın; ort. yaş 38.6±10.2 yıl; dağılım 22-59 yıl larengeal EMG yapıldı ve nörojenik tutulum varlığı değerlendirildi.Bulgular: Larengostroboskopik muayenede hastaların %85.7’sinde n=24 polip, %10.7’sinde n=3 Reinke ödemi, %10.7’sinde n=3 submüköz kist, %3.6’sında n=1 kontakt granülom vardı. Hastaların %14.2’sinde n=4 muayenede vokal kord parezisinden şüphelenildi. Larengeal EMG değerlendirilmesinde hastaların %57.2’sinde n=16 bir veya birden fazla larenks kasında nörojenik tutulum bulgusu saptandı. Hastaların sekizinde %28.6 nörojenik tutulum tek taraflı iken, üçünde %10.7 izole reküren larengeal sinir parezisi, ikisinde %7.2 izole süperior larengeal sinir parezisi ve üçünde ise %10.7 kombine tek taraflı reküren ve superior larengeal sinir parezisi vardı. İki taraflı nörojenik tutulum olan sekiz hastanın %28.6 altısında %21.4 üç larengeal sinirde, ikisinde %7.2 ise dört larengeal sinirde nörojenik tutulum saptandı.Sonuç: Bu çalışmada vokal kord parezisinin benign vokal kord lezyonlarına yüksek oranda eşlik edebileceği gösterilmiştir. Larengeal EMG klinik olarak şüphe edilen veya muayenede şüphelenilmeyen parezinin kesin olarak tanınmasını sağlar

Anahtar Kelimeler

Benign vokal kord lezyonu, larengeal elektromiyografi, laringostroboskopi, vokal kord paralizisi, vokal kord parezisi

Kaynakça

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