Principles and Practices of Laryngeal Electromyography

WEN XU, MD, PhD, Professor, Director, Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University. She is Chairman of Voice Committee of Chinese Medical Association of Otorhinolaryngology Head & Neck Surgery and Deputy Editor of Journal of Audiology and Speech Pathology (Chinese). She is an Editorial Board Member of Journal of Voice and an Editorial Board Member of Chinese Journal of Otorhinolaryngology and Head Neck Surgery.

• PREFACE viiiACKNOWLEDGMENT ixPart I Basis of Laryngeal Electromyography 11 Anatomy of the Larynx 31.1 Laryngeal Muscles 31.1.1 Glottic Dilator Muscles (Muscles That Abduct the Vocal Folds) 31.1.2 Muscles That Adduct the Vocal Folds 41.1.3 Vocal Fold Tension/Relaxation Muscles 61.1.4 Epiglottis Movement Muscles 61.1.5 Classification of Laryngeal Muscle Fibers 61.2 Laryngeal Nerves 71.2.1 Superior Laryngeal Nerve 71.2.2 Recurrent Laryngeal Nerve 71.2.3 Sympathetic Nerve 101.2.4 Anastomoses 101.2.5 Lower Cranial Nerves 102 Physiology of the Larynx 122.1 Phonation 122.1.1 Power Source 122.1.2 Oscillator 132.1.3 Resonator and Articulator 132.1.4 Regulatory Organs 132.2 Respiratory Function 142.3 Protection Function 142.4 Assistance Function in Swallowing 152.5 Larynx and Circulatory Reflex 152.6 Emotional Expression 153 Laryngeal Electromyography 173.1 Overview 173.2 Recording System and Electrode in Electromyography 193.2.1 Recording System 193.2.2 Types of Electrodes 193.3 Needle Electromyography 253.3.1 Parameters 253.3.2 Abnormal Electromyographic Activity 293.4 Laryngeal Needle Electromyography 323.4.1 Technique 343.4.2 Electromyographic Characteristics 383.5 Laryngeal Nerve Conduction Study 413.5.1 Basic Principles 423.5.2 Procedures 433.6 Characteristics of Laryngeal Evoked Potentials 443.7 Other Electrophysiological Examinations 473.7.1 Repetitive Nerve Stimulation 473.7.2 Single-Fiber Electromyography 493.7.3 Cortical Motor Evoked Potential 493.8 Principles and Precautions in Electromyography 503.8.1 Basic Principles 503.8.2 Safety and Precautions 50Part II Abnormal Laryngeal Electromyographic Manifestation and Case Study 534 Vocal Fold Paralysis 554.1 Clinical Characteristics 554.1.1 Etiology 554.1.2 Pathophysiological Mechanisms 554.1.3 Clinical Manifestation 564.1.4 Diagnosis 564.1.5 Prognosis Evaluation 604.2 Case Study 615 Vocal Fold Paralysis with Lower Cranial Nerve Injury 725.1 Clinical Characteristics 725.1.1 Physical Signs of Lower Cranial Nerve Injury 725.1.2 Characteristics of Vocal Fold Paralysis with Lower Cranial Nerve Injury 735.2 Case Study 736 Mechanical Vocal Fold Immobility 836.1 Arytenoid Dislocation 836.1.1 Clinical Characteristics 836.1.2 Case Study 856.2 Posterior Glottic Stenosis 926.2.1 Clinical Characteristics 926.2.2 Case Study 926.3 Laryngeal Chondroma 956.3.1 Clinical Characteristics 956.3.2 Case Study 967 Laryngeal Myopathy 1007.1 Clinical Characteristics 1007.2 Case Study 1018 Myasthenia Gravis 1058.1 Clinical Characteristics 1058.1.1 Etiology and Pathophysiological Mechanism 1058.1.2 Clinical Manifestation 1068.1.3 Examination 1068.1.4 Diagnosis and Differential Diagnosis 1078.2 Case Study 1079 Spasmodic Dysphonia 1129.1 Clinical Characteristics 1129.1.1 Etiology and Pathogenesis 1129.1.2 Clinical Manifestations 1129.1.3 Laryngeal Electromyography 1139.1.4 Diagnosis and Differential Diagnosis 1149.1.5 Treatment and Prognosis 1149.2 Case Study 11510 Functional Dysphonia 12210.1 Clinical Characteristics 12210.2 Case Study 122References 128INDEX 129