Ann Rehabil Med.  2017 Dec;41(6):1019-1027. 10.5535/arm.2017.41.6.1019.

Comparison of Clinical Characteristics Between Patients With Different Causes of Vocal Cord Immobility

• Kim MH
• Noh J
• Pyun SB

• KMID: 2400287
• DOI: http://doi.org/10.5535/arm.2017.41.6.1019

Abstract

OBJECTIVE
To analyze the clinical characteristics between neurogenic and non-neurogenic cause of vocal cord immobility (VCI).
METHODS
The researchers retrospectively reviewed clinical data of patients who underwent laryngeal electromyography (LEMG). LEMG was performed in the bilateral cricothyroid and thyroarytenoid muscles. A total of 137 patients were enrolled from 2011 to 2016, and they were assigned to either the neurogenic or non-neurogenic VCI group, according to the LEMG results. The clinical characteristics were compared between the two groups and a subgroup analysis was done in the neurogenic group.
RESULTS
Among the 137 subjects, 94 patients had nerve injury. There were no differences between the neurogenic and non-neurogenic group in terms of demographic data, underlying disease except cancer, and premorbid events. In general characteristics, cancer was significantly higher in the neurogenic group than non-neurogenic group (p=0.001). In the clinical findings, the impaired high pitched "˜e' sound and aspiration symptoms were significantly higher in neurogenic group (p=0.039 for impaired high pitched "˜e' sound; p=0.021 for aspiration symptoms), and sore throat was more common in the non-neurogenic group (p=0.014). In the subgroup analysis of neurogenic group, hoarseness was more common in recurrent laryngeal neuropathy group than superior laryngeal neuropathy group (p=0.018).
CONCLUSION
In patients with suspected vocal cord palsy, impaired high pitched "˜e' sound and aspiration symptoms were more common in group with neurogenic cause of VCI. Hoarseness was more frequent in subjects with recurrent laryngeal neuropathy. Thorough clinical evaluation and LEMG are important to differentiate underlying cause of VCI.

Keyword

Vocal cord paralysis; Electromyography; Laryngeal nerves; Recurrent laryngeal nerve

MeSH Terms

Electromyography
Hoarseness
Humans
Laryngeal Muscles
Laryngeal Nerves
Pharyngitis
Recurrent Laryngeal Nerve
Retrospective Studies
Vocal Cord Paralysis
Vocal Cords*

Figure

• 

  Fig. 1 Surface landmark of larynx is illustrated. We drew line to indicate lower border of thyroid cartilage, upper and lower borders of cricoid cartilage, midline of cricothyroid membrane.

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