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Laryngeal electromyography for prognosis of vocal fold palsy: A Meta‐Analysis
Author(s) -
Rickert Scott M.,
Childs Lesley F.,
Carey Bridget T.,
Murry Thomas,
Sulica Lucian
Publication year - 2012
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.22354
Subject(s) - confidence interval , medicine , odds ratio , electromyography , likelihood ratios in diagnostic testing , diagnostic odds ratio , palsy , meta analysis , physical medicine and rehabilitation , pathology , alternative medicine
Objectives/Hypothesis: To analyze existing evidence regarding utility of laryngeal electromyography (LEMG) for prognosis in cases of vocal fold palsy (VFP). Study Design: Meta‐analysis of studies reporting LEMG results and clinical outcomes in 503 patients with of VFP identified by literature search. Methods: Studies were identified by literature search. Method of diagnosis, interval to LEMG, criteria for prognostication, and outcome were assessed. Criteria for prognosis were standardized to the extent possible across all studies, and studies were checked for consistency in outcome measures and assessments. Pooled data were subjected to statistical analysis. Results: A total of 296/503 patients (58.8%) had findings predictive with poor prognosis, whereas 207/503 (41.2%) had findings of recovery. According to laryngoscopic examination, 269/296 patients with predicted poor recovery had poor recovery (positive predictive value = 90.9%), whereas 27/296 (9.1%) had good recovery. In patients with findings consistent with recovery, 115/207 (negative predictive value = 55.6%) noted return of motion, whereas 88/207 (44.4%) did not. The odds ratio was 11.56 with 95% confidence interval of 7.10‐18.81. Conclusions: LEMG is a good predictor of poor recovery in patients with VFP and is clinically useful in identifying candidates for early definitive intervention.