Description
A comprehensive clinical guide to Laryngeal Electromyography (LEMG) for the diagnosis, treatment, and prognosis of voice and swallowing disorders
Principles and Practices of Laryngeal Electromyography combines electrophysiological theory with clinical practice to provide an authoritative yet accessible overview of Laryngeal Electromyography (LEMG). This essential resource equips clinicians with the scientific foundation needed to diagnose, treat, and determine prognosis for laryngeal immobility—including organic neuromuscular paralysis and cricoarytenoid joint abnormalities—as well as swallowing disorders, spasmodic dysphonia, and other laryngeal neuromuscular pathologies.
Featuring over 180 original clinical illustrations and 18 detailed case studies, this book bridges the gap between LEMG fundamentals and practical clinical applications, making this specialized technique more accessible to practitioners.
Principles and Practices of Laryngeal Electromyography covers:
- Applied anatomy and physiology of LEMG, including recorder and electrode selection, needle-electrode electromyography techniques, and evaluation parameters
- Basic LEMG principles and operation, the laryngeal nerve conduction testing, and specialized electrophysiological tests, including repetitive nerve stimulation and single-fibre electromyography
- Clinical applications in vocal fold paralysis, including cases with lower cranial nerve injury and mechanical vocal fold immobility
- Neuromuscular disorders affecting the larynx, including laryngeal myopathy, myasthenia gravis, spasmodic dysphonia, and functional dysphonia
Principles and Practices of Laryngeal Electromyography is an indispensable reference for otolaryngologists, laryngologists, neurologists, physiatrists, residents, and other healthcare professionals seeking to master LEMG techniques and improve patient outcomes in voice and swallowing disorders.
Table of Contents
Preface viii
Acknowledgment ix
Part I Basis of Laryngeal Electromyography 1
1 Anatomy of the Larynx 3
1.1 Laryngeal Muscles 3
1.1.1 Glottic Dilator Muscles (Muscles That Abduct the Vocal Folds) 3
1.1.2 Muscles That Adduct the Vocal Folds 4
1.1.3 Vocal Fold Tension/Relaxation Muscles 6
1.1.4 Epiglottis Movement Muscles 6
1.1.5 Classification of Laryngeal Muscle Fibers 6
1.2 Laryngeal Nerves 7
1.2.1 Superior Laryngeal Nerve 7
1.2.2 Recurrent Laryngeal Nerve 7
1.2.3 Sympathetic Nerve 10
1.2.4 Anastomoses 10
1.2.5 Lower Cranial Nerves 10
References 11
2 Physiology of the Larynx 12
2.1 Phonation 12
2.1.1 Power Source 12
2.1.2 Oscillator 12
2.1.3 Resonator and Articulator 13
2.1.4 Regulatory Organs 13
2.2 Respiratory Function 14
2.3 Protection Function 14
2.4 Assistance Function in Swallowing 15
2.5 Larynx and Circulatory Reflex 15
2.6 Emotional Expression 15
References 15
3 Laryngeal Electromyography 17
3.1 Overview 17
3.2 Recording System and Electrode in Electromyography 19
3.2.1 Recording System 19
3.2.2 Types of Electrodes 19
3.3 Needle Electromyography 25
3.3.1 Parameters 25
3.3.2 Abnormal Electromyographic Activity 29
3.4 Laryngeal Needle Electromyography 32
3.4.1 Technique 34
3.4.2 Electromyographic Characteristics 38
3.5 Laryngeal Nerve Conduction Study 41
3.5.1 Basic Principles 42
3.5.2 Procedures 43
3.6 Characteristics of Laryngeal Evoked Potentials 44
3.7 Other Electrophysiological Examinations 47
3.7.1 Repetitive Nerve Stimulation 47
3.7.2 Single-Fiber Electromyography 49
3.7.3 Cortical Motor Evoked Potential 49
3.8 Principles and Precautions in Electromyography 50
3.8.1 Basic Principles 50
3.8.2 Safety and Precautions 50
References 51
Part II Abnormal Laryngeal Electromyographic Manifestation and Case Study 53
4 Vocal Fold Paralysis 55
4.1 Clinical Characteristics 55
4.1.1 Etiology 55
4.1.2 Pathophysiological Mechanisms 55
4.1.3 Clinical Manifestation 56
4.1.4 Diagnosis 56
4.1.5 Prognosis Evaluation 60
Case Study 61
References 71
5 Vocal Fold Paralysis with Lower Cranial Nerve Injury 72
5.1 Clinical Characteristics 72
5.1.1 Physical Signs of Lower Cranial Nerve Injury 72
5.1.2 Characteristics of Vocal Fold Paralysis with Lower Cranial Nerve Injury 73
5.2 Case Study 73
References 82
6 Mechanical Vocal Fold Immobility 83
6.1 Arytenoid Dislocation 83
6.1.1 Clinical Characteristics 83
6.1.2 Case Study 85
6.2 Posterior Glottic Stenosis 92
6.2.1 Clinical Characteristics 92
6.2.2 Case Study 92
6.3 Laryngeal Chondroma 95
6.3.1 Clinical characteristics 95
6.3.2 Case Study 96
References 99
7 Laryngeal Myopathy 100
7.1 Clinical Characteristics 100
7.2 Case Study 101
References 104
8 Myasthenia Gravis 105
8.1 Clinical Characteristics 105
8.1.1 Etiology and Pathophysiological Mechanism 105
8.1.2 Clinical Manifestation 106
8.1.3 Examination 106
8.1.4 Diagnosis and Differential Diagnosis 107
8.2 Case Study 107
References 111
9 Spasmodic Dysphonia 112
9.1 Clinical Characteristics 112
9.1.1 Etiology and Pathogenesis 112
9.1.2 Clinical Manifestations 112
9.1.3 Laryngeal Electromyography 113
9.1.4 Diagnosis and Differential Diagnosis 114
9.1.5 Treatment and Prognosis 114
9.2 Case Study 115
References 121
10 Functional Dysphonia 122
10.1 Clinical Characteristics 122
10.2 Case Study 122
References 128
Index 000
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