Elizabeth Ho1, Samuel Goorman2, Iram Zaman3, Anza Memon4, Lonni Schultz1
1Henry Ford Hospital, 2Wayne State University, Henry Ford Hospital - Detroit, MI, 3Henry Ford Hospital, Wayne State University, 4John D. Dingell, VAMC, Henry Ford Hospital, Detroit, Michigan
Objective:
The primary objective of this research study is to gain understanding of electrophysiological findings and value of repeat EMG/NCS for prognostication in patients with laryngeal neuropathies.
Background:
Laryngeal neuropathy presents as an infrequently diagnosed cause of vocal dysfunction with symptoms including cough, voice changes, difficulty swallowing, and throat pain.
Design/Methods:
This single center retrospective study aimed to summarize various clinical features of laryngeal neuropathy A total of 52 patients with laryngeal and vagal neuropathies diagnosed over a 22-year period, 2000 to 2022 were evaluated. Demographic, clinical and electrodiagnostic data were collected, and descriptive statistics were used to analyze the variables of interest. The variables of interest included etiology, symptoms, time to diagnosis from symptom onset, treatment, race, sex, prognosis, and electromyography (EMG) findings.
Results:
Of the 52 patients evaluated, surgery related trauma (n=23; 44%) was the most common etiology, and speech difficulty (n=49; 94%) was the most common symptom. Based on diagnoses made through EMG, 25 patients (48%) had vagal neuropathy, 8 (15%) had recurrent vagal neuropathy, 13 (25%) had other laryngeal conditions. Treatments including surgical repair, speech therapy, medical therapy, and several others led to improvement or complete resolution in 23 (44%) patients. No significant difference in time to diagnosis was observed based on sex or race. Patients with post-surgical etiology had a significantly shorter time to diagnosis (p=.015).
Conclusions:
Laryngeal neuropathies are commonly associated with vocal cord dysfunction leading to significant speech impairment. Surgical trauma was the most common cause in our patient group, followed by idiopathic causes. Electrodiagnostic findings, including EMG studies, aid in the definitive diagnosis. The shorter time to diagnosis in patients who develop post-surgical manifestation may be due to in-patient post-surgical status enabling faster evaluation.