Project Details
Abstract
Background: The function of muscle corresponds to the neuromuscular control, which can be measured
by electromyography (EMG). At present, laryngeal EMG is a qualitative examination when establishing
whether motor unit recruitment is normal or abnormal. Thus the report of tone and function of intrinsic
laryngeal muscle was limited. Vocal cord position in patients with unilateral recurrent laryngeal nerve
paralysis may change over time. Vocal cord position has been shown to correlate with patients’voice and
swallowing outcomes. Recent studies revealed that early administration of temporary intracordal injection
would influence long-term vocal position and vocal function, a finding that supports the efficacy of early
injection but, however, its mechanism was unclear. Some suggested mechanical medializing force by
temporary substances and following fibrosis fixed the cord in median position while others suggest that
vibro-tactile stimulation induced by contacting the contralateral mobile cord reduces misrouting axons
while regenerating and thus improves the outcome. It is thus of utmost interest to investigate the
relationship among acting motor potential, vocal cord position and vocal function. Interference pattern
analysis for quantitative laryngeal electromyography data (denoted as Q-LEMG) is a novel methodology
that provides a reliable measurement of the level of motor unit recruitment. In our preliminary data,
interference level computed by Q-LEMG positively correlates with Voice Outcome Survey scores, a
novel observation supporting the hypothesis that voice impairment is predominately determined by the
level of remaining neuronal motor inputs. Thus, the determinants of vocal cord position change remain
unclear.
Purposes: 1. Evaluate the correlation of EMG activity of intrinsic laryngeal muscle and vocal cord
position and its impaction on vocal functions. 2. To search for the predictors of vocal fold position in
paralyzed larynx by Q-LEMG. 3. Detect the differences of recruitment between early hyaluronic acid
injection and observation group and clarify the mechanism of temporary intracordal injection.
Study designs: The present four-year project will enroll 120 patients with unilateral recurrent laryngeal
nerve paralysis. According to the interval from the onset of injury and time of therapy, patients will be
divided into 3 groups: Group A includes 40 patients that had damage over 12 months, group B 40 cases of
acute RLN injury who accept a conventional observation policy of therapy and group C 40 acute RLN
injury patients that will undergo hyaluronan intracordal injection within six-month from RLN damage. At
every follow-up, we will obtain the Q-LEMG data, vocal cord position, voice laboratory data and quality
of life.
Predictive outcomes: 1. Confirm the predicting roles of recruitment ratio and interference pattern
measured by Q-LEMG on the change of paralyzed vocal cord position. 2. Achieve the correlation of the
neuromuscular control of intrinsic laryngeal muscle and vocal fold position. 3. Analyze the impaction of
early temporary injection on long term neuromuscular control in intrinsic laryngeal muscle.
Project IDs
Project ID:PC10107-0347
External Project ID:NSC101-2314-B182A-106
External Project ID:NSC101-2314-B182A-106
Status | Finished |
---|---|
Effective start/end date | 01/08/12 → 31/07/13 |
Keywords
- quantitative laryngeal electromyography
- recurrent laryngeal nerve paralysis
- muscle tone
- laryngeal electromyography
- injection laryngoplasty
- outcomes measurement
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