Using Laryngeal Electromyography to Differentiate Presbylarynges From Paresis PurposeDifferential diagnosis of patients over 64 years of age reporting hoarseness is challenging. Laryngeal electromyography (LEMG) was used to determine the status of the recurrent and superior laryngeal nerves. The authors hypothesized that individuals with hoarseness but normal LEMG would have measures similar to those of patients from previous studies ... Article
Article  |   February 01, 2010
Using Laryngeal Electromyography to Differentiate Presbylarynges From Paresis
 
Author Affiliations & Notes
  • Sheila V. Stager
    The George Washington University Medical Center, Washington, DC
  • Steven A. Bielamowicz
    The George Washington University Medical Center, Washington, DC
  • Contact author: Sheila V. Stager, Voice Treatment Center, Medical Faculty Associates, The George Washington University Medical Center, 2150 Pennsylvania Avenue NW, Suite 6-301, Washington, DC 20037. E-mail: stager@mfa.gwu.edu.
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Special Populations / Genetic & Congenital Disorders / Older Adults & Aging / Speech, Voice & Prosody / Speech
Article   |   February 01, 2010
Using Laryngeal Electromyography to Differentiate Presbylarynges From Paresis
Journal of Speech, Language, and Hearing Research, February 2010, Vol. 53, 100-113. doi:10.1044/1092-4388(2009/08-0244)
History: Received December 1, 2008 , Accepted July 8, 2009
 
Journal of Speech, Language, and Hearing Research, February 2010, Vol. 53, 100-113. doi:10.1044/1092-4388(2009/08-0244)
History: Received December 1, 2008; Accepted July 8, 2009
Web of Science® Times Cited: 9

PurposeDifferential diagnosis of patients over 64 years of age reporting hoarseness is challenging. Laryngeal electromyography (LEMG) was used to determine the status of the recurrent and superior laryngeal nerves. The authors hypothesized that individuals with hoarseness but normal LEMG would have measures similar to those of patients from previous studies with presbylarynges and significantly different from those of patients with abnormal LEMG.

MethodA retrospective chart review of acoustic, aerodynamic, endoscopic, and self-rating measures was completed for 52 individuals over 64 years of age reporting moderate to severe hoarseness.

ResultsIndividuals with normal LEMG had measures similar to those of patients from previous studies diagnosed with presbylarynges. The group with LEMG abnormalities was subcategorized by specific nerve(s) affected. Significant differences were found for measures between presbylarynges and unilateral but not bilateral paresis groups. Several endoscopic findings were observed more often than expected in the presbylarynges group. Using electromyography as a gold standard, the presence of any impairment in arytenoid movement had the most sensitivity (77%) in making the diagnosis of paresis, and the absence of any impairment had the most specificity (67%) in making the diagnosis of presbylarynges.

ConclusionLEMG may be useful in differentially diagnosing hoarseness in older patients, especially to distinguish between bilateral paresis and presbylarynges.

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