喉頭における誘発筋電図検査

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This study was performed to apply an evoked EMG test to the larynx and to find out whether this test is valuable or not for diagnosis of patients with recurrent nerve palsy.Three types of evoked EMG wave were obtained from the ipsilateral intrinsic laryngeal muscles by giving electrical stimuli to three different sites. These were; from the cricothyroid by stimulation to the internal branch of the superior laryngeal nerve and from the thyroarytenoid by stimulation to the recurrent nerve and to the vagus nerve. A concentric needle electrode was used as a leading electrode. A pair of copper wire (diameter 80/μ) insulated except for a length of 5 mm at the tip was used as a stimulus electrode. Stimuli were rectangular current pulses of 1 msec duration and given at supramaximal level.In ten normal subjects, evoked wave induced by stimulation to the superior laryngeal nerve was polyphasic, while di-or triphasic by stimulation to the other nerves. The latency, duration and amplitude of evoked waves were examined. Threshold was not available because distance between the nerve and electrodes differed for case.Seven cases of recurrent nerve palsy were then examined. As a result, it was considered that the present test was valuable for the followings;1. Diagnosis of the site of lesion: the decision is easily made on whether the recurrent nerve alone or together with the superior laryngeal nerve is damaged, and on the damaged site along the recurrent laryngeal nerve in some cases.2. Inference of prognosis: Those cases showing no evoked wave may not recover completely. For the cases showing an evoked wave, information on prognosis can be obtained from the degree of changes in latency and evoked wave form.Information on reinnervation of the paralysed nerve: the evoked EMG test is able to revealthe condition of reinnervation as ordinary EMG test. Moreover, this test gives information on reinnervation at the earlier period than ordinary EMG test after the onset laryngeal nerve palsy.
社団法人日本耳鼻咽喉科学会の論文

喉頭における誘発筋電図検査

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