Open AccessA New Classification of Laryngeal Synkinesis
Author(s) -
Yumoto Eiji,
Nishimoto Kohei,
Sanuki Tetsuji,
Kumai Yoshihiko,
Toya Yutaka
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811415823a180
Subject(s) - synkinesis , phonation , medicine , electromyography , vocal fold paralysis , recurrent laryngeal nerve , surgery , audiology , physical medicine and rehabilitation , paralysis , pathology , alternative medicine , thyroid , palsy
Objective 1) Develop a new classification of laryngeal synkinesis in patients with unilateral vocal fold paralysis (UVFP) based on images of the vocal fold using 3‐dimensional computed tomography (3DCT) 2) Compare synkinesis type based on 3DCT image analysis with recruitment in electromyography during phonation. Method Retrospective. Subjects included 50 patients with UVFP who underwent framework surgeries between 2000 and 2010. Three‐dimensional images during phonation and inhalation preoperatively were assessed focusing on thickness of the affected fold to classify synkinesis. Recruitment of thyroarytenoid muscle was rated and compared with synkinesis type. Results Two subjects were excluded because of poor performance during scanning. Three synkinesis types were identified. The affected fold in 12 subjects showed some degree of thickening during phonation. The affected fold of the remaining 36 was thin during phonation. Thickening of the affected fold was evident during inhalation in 20 of the 36 subjects, while the affected fold in the rest (16 subjects) remained to be thin. Thirty‐one subjects underwent electromyography. Those with the latter 2 types of synkinesis had a tendency of less recruitment compared with those with the former type of synkinesis. Conclusion The use of the new classification of laryngeal synkinesis facilitates understanding of behavior of the affected vocal fold in patients with UVFP. The number of subjects who underwent electromyography was not sufficient to draw a conclusion about the relation between synkinesis classification and recruitment.