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The role of laryngeal electromyography in vagus nerve stimulation-related vocal fold dysmotility

  • Laryngology
  • Published:
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Abstract

Vagus nerve stimulation (VNS) is a useful tool for drug-resistant epilepsy, but it induces known laryngeal side effects, with a significant role on patients’ quality of life. VNS patients may show persistent left vocal fold (LVF) palsy at rest and/or recurrent LVF adduction during stimulation. This study aims at electromyographically evaluating laryngeal muscles abnormalities in VNS patients. We compared endoscopic laryngeal evaluation data in six VNS patients with laryngeal muscle electromyography (LMEMG) carried out on the thyroarytenoid, cricothyroid, posterior cricoarytenoid, and cricopharyngeal muscles. Endoscopy showed LVF palsy at rest in 3/6 patients in whom LMEMG documented a tonic spastic activity with reduced phasic modulation. In four out of six patients with recurrent LVF adduction during VNS activation, LMEMG showed a compound muscle action potential persisting for the whole stimulation. This is the first LMEMG report of VNS-induced motor unit activation via recurrent laryngeal nerve and upper laryngeal nerve stimulation. LMEMG data were could, therefore, be considered consistent with the endoscopic laryngeal examination in all patient.

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Authors and Affiliations

  1. Otolaryngology Unit, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy

    Alberto M. Saibene, Carlotta Pipolo, Alberto Maccari, Giovanni Felisati & Elena Felisati

  2. Regional Centre for Epilepsy, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy

    Elena Zambrelli, Francesca Furia, Aglaia Vignoli & Maria Paola Canevini

  3. Neurophysiopathology Service, Diagnostic Services Department, Neurological Institute “C. Mondino”, Pavia, Italy

    Enrico Alfonsi

Authors
  1. Alberto M. Saibene
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  2. Elena Zambrelli
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  3. Carlotta Pipolo
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  4. Alberto Maccari
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  5. Giovanni Felisati
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  6. Elena Felisati
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  7. Francesca Furia
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  8. Aglaia Vignoli
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  9. Maria Paola Canevini
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  10. Enrico Alfonsi
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Corresponding author

Correspondence to Alberto M. Saibene.

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The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cite this article

Saibene, A.M., Zambrelli, E., Pipolo, C. et al. The role of laryngeal electromyography in vagus nerve stimulation-related vocal fold dysmotility. Eur Arch Otorhinolaryngol 274, 1585–1589 (2017). https://doi.org/10.1007/s00405-016-4344-3

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  • DOI: https://doi.org/10.1007/s00405-016-4344-3

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