RUOkie

10+ Year Member
7+ Year Member
Mar 3, 2009
760
54
Status
Attending Physician
I was approached by an ENT friend who asked me about laryngeal EMG. He has a woman with bilateral vocal cord paralysis after a thyroid surgery (now with a trach) who he thinks will need it for prognosis.

I discussed with him that he could do the needle stick, and I would do the waveform analysis (since he could insert the needle while under direct laryngoscopy).

Anybody ever do this?
 

Tap0utt

Member
7+ Year Member
15+ Year Member
Dec 16, 2003
36
0
Visit site
Status
ive seen the neuromuscular doc do just as you said. the ent does the anesthesizing and insertion while the neurogist guides him in terms of distance vs incorrect muscle placement vs correct placement.
 

nvrsumr

Member
15+ Year Member
Apr 25, 2002
1,942
497
na.com
Status
Attending Physician
I did a few of these as a resident but without ENT or laryngoscope. Not super difficult but then again I wasnt ultimately responsible. Looks like a lecture on the topic is being given at the AANEM meeting.
 
About the Ads

Bombesin

Awesomeness Embodied
10+ Year Member
Jun 21, 2009
58
0
Status
Attending Physician
I did a few of these as a resident but without ENT or laryngoscope. Not super difficult but then again I wasnt ultimately responsible. Looks like a lecture on the topic is being given at the AANEM meeting.
The lecturer is actually one of the PM&R physicians here at UPMC that performs these on a regular basis in conjunction with ENT.
 
Dec 1, 2011
10
0
Status
Resident [Any Field]
Inquiring mind wishes to know: what prognostic information do you obtain from vocal cord EMG's? Here's my line of thought....Stick the muscle, if there's motor units, then there likely will be enough peripheral sprouting to gain functional strength. If there's no units, then complete denervation, poor prognosis. In this case you already have an etiology from the surgery (unless diagnostically, you think this is not denervation and that's what you're trying to prove). And if you get no motor units, do the surgeons like to head in the jungle to reconnect/graft the recurrent laryng. nerve? If not, then it's all conservative management, and is there a good reason to do the EMG at all? I'm curious....because if our institution does it, I just don't about it.

Thanks!
 

RUOkie

10+ Year Member
7+ Year Member
Mar 3, 2009
760
54
Status
Attending Physician
Inquiring mind wishes to know: what prognostic information do you obtain from vocal cord EMG's? Here's my line of thought....Stick the muscle, if there's motor units, then there likely will be enough peripheral sprouting to gain functional strength. If there's no units, then complete denervation, poor prognosis. In this case you already have an etiology from the surgery (unless diagnostically, you think this is not denervation and that's what you're trying to prove). And if you get no motor units, do the surgeons like to head in the jungle to reconnect/graft the recurrent laryng. nerve? If not, then it's all conservative management, and is there a good reason to do the EMG at all? I'm curious....because if our institution does it, I just don't about it.

Thanks!
it would be done for prognostic reasons only. The ENT wanted the information for academic purposes only. And the point was moot. The lady has no-showed to her last 2 visits with the surgeon anyway.
 

lobelsteve

SDN Lifetime Donor
Lifetime Donor
15+ Year Member
May 30, 2005
14,879
4,671
Canton GA
www.stevenlobel.com
Status
Attending Physician
We did it 2 mornings per month for ENT clinic. They did Botox for spasmodic dysphonia and we did the EMG guidance. Boring.
 
About the Ads