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Arch Otolaryngol Head Neck Surg. 2008 Apr;134(4):380-8. doi: 10.1001/archotol.134.4.380.

Prognostic indicators of unilateral vocal fold paralysis.

Author information

  • 1School of Medicine, National Defense Medical Center, and Department of Medicine, Chung-Shan Medical University, Taichung, Taiwan. ccwang@vghtc.gov.tw

Abstract

OBJECTIVES:

To determine the possible prognostic indicators of unilateral vocal fold paralysis (UVFP) and survey the timing and values of preset laryngeal electromyography (LEMG) rules for UVFP.

DESIGN:

Cohort study with retrospective data analysis.

SETTING:

Voice clinic of a tertiary medical center.

PATIENTS:

Complete data for 45 patients diagnosed with idiopathic or iatrogenic UVFP. The LEMG was performed between 3 weeks and 6 months from the onset of symptoms.

MAIN OUTCOME MEASURE:

At least 6 months after symptom onset and 3 months after LEMG.

RESULTS:

Thirteen subjects showed resolved vocal fold motion (29%), and 32 had persistent vocal fold paralysis (71%). According to the LEMG decision rules proposed by Munin et al in 2003, the predictive values for positive results, negative results, sensitivity, specificity, and accuracy of LEMG were 78.9%, 71.4%, 93.8%, 38.5%, and 77.8%, respectively. We found the false-positive rate to be as high as 50% if LEMG was performed less than 2 months after symptom onset, and only 7.7% if LEMG was performed at least 2 months after symptom onset. After excluding 14 LEMG data recorded at less than 2 months, the predictive values for positive results, negative results, sensitivity, specificity, and accuracy of LEMG were 92.3%, 60%, 92.3%, 60.0%, and 87.1%, respectively. The predictive values of positive results and accuracy significantly improved without compromising sensitivity.

CONCLUSION:

This study confirms that LEMG is a clinically useful tool that can offer prognostic information for UVFP especially if it is done at least 2 months after symptom onset.

[PubMed - indexed for MEDLINE]
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