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  • Title: Electromyography in children's laryngeal mobility disorders: a proposed grading system.
    Author: AlQudehy Z, Norton J, El-Hakim H.
    Journal: Arch Otolaryngol Head Neck Surg; 2012 Oct; 138(10):936-41. PubMed ID: 23069824.
    Abstract:
    OBJECTIVES: To describe a consecutive series of children with laryngeal mobility disorders assessed by laryngeal electromyography (LEMG), to propose a grading system for LEMG findings, and to determine whether the LEMG grades correlate with requirement for tracheostomy. DESIGN: Retrospective, observational, uncontrolled study. SETTING: A single pediatric otolaryngology practice. PATIENTS: Children who had LEMG performed and a minimum follow-up of 3 months. MAIN OUTCOME MEASURES: Demographic characteristics, diagnoses, surgical procedures, number of LEMG procedures, and complications were obtained. The LEMG results from the thyroarytenoid and posterior cricoarytenoid muscles were graded 0 to 4 according to amplitude and relation to the phase of respiration. A correlation analysis between the need for tracheostomy and the baseline LEMG score as well as a multivariable analysis to determine the predictors of requirement for tracheostomy were performed. RESULTS: Between April 28, 2008, and November 2, 2011, 43 LEMG procedures were performed on 23 patients (13 girls; mean [SD] age, 1.5 [2.85] years). Eight required tracheostomy. Among the 23 patients, 16 had laryngeal paralysis (11 bilateral, 5 unilateral), 4 had laryngeal dyskinesia, and 3 had miscellaneous conditions. Fourteen had secondary large airway lesions, and 14 had a nonairway diagnosis that affected respiration. The overall LEMG results correlated negatively with requirement for tracheostomy (r = -0.4; P < .05) and were 86.36% accurate compared with endoscopy. No predictors for tracheostomy were identified. CONCLUSIONS: The LEMG grading was accurate and correlated with the requirement for tracheostomy. Combined with endoscopy, the grading may help better characterize laryngeal mobility disorders.
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