Pediatric laryngeal electromyography

Abstract

Vocal fold immobility (VFI) is a challenging management issue in pediatric otolaryngology. VFI is most commonly distinguished between unilateral (UVFI) and bilateral (BVFI) dysfunction. UVFI and BVFI are different pathophysiologic and clinical entities with distinct symptoms and etiologies. It has been generally accepted in the adult literature to wait at least 1 year prior to carrying out more permanent type procedures for VFI. This period has been extended out even further in children as the literature has suggested that vocal fold function may return many years later. Unfortunately, there is no simple test or procedure to help predict return of vocal fold function. In adult patients LEMG has been used to help guide management decisions, but it has not been widely investigated in children. In this chapter the authors describe a LEMG technique that has been a useful adjunct in managing children with VFI.