Name of the Procedure:

Needle Electromyography of the Larynx (Needle EMG; Laryngeal EMG)

Summary

Needle Electromyography of the larynx is a diagnostic test used to evaluate the electrical activity of muscles and nerves in the voice box (larynx). A small, thin needle electrode is inserted into the muscles to measure their activity while in use and at rest.

Purpose

This procedure is primarily used to investigate voice disorders, muscle weaknesses, or nerve dysfunctions in the larynx. The goal is to diagnose the underlying cause of symptoms such as hoarseness, breathiness, vocal fatigue, or complete loss of voice.

Indications

• Persistent hoarseness or voice changes
• Vocal cord paralysis or paresis
• Suspected nerve damage impacting the vocal cords
• Chronic laryngitis
• Difficulty speaking or swallowing

Preparation

• Patients may be advised to refrain from eating or drinking for a few hours before the procedure.
• Adjustments to certain medications may be necessary.
• Pre-procedure assessments such as a laryngoscope examination may be performed to visually inspect the larynx.

Procedure Description

1. The patient is seated comfortably and local anesthesia may be applied to minimize discomfort.
2. A small, thin needle electrode is gently inserted through the skin into the laryngeal muscles.
3. The patient will be asked to perform specific vocal tasks to activate the laryngeal muscles.
4. Electrical activity is recorded and interpreted by the specialist.
5. The needle is carefully removed after the recordings are complete.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Needle EMG of the larynx is usually performed in an outpatient clinic or a hospital setting.

Personnel

• Otolaryngologist (ENT specialist)
• Neurologist or specialist in electromyography
• Trained nurse or medical assistant

Risks and Complications

• Mild discomfort or pain at the needle insertion site
• Localized bleeding or bruising
• Risk of infection at the needle insertion site (rare)
• Temporary voice changes or soreness

Benefits

• Accurate diagnosis of neuromuscular or nerve-related voice disorders
• Helps guide appropriate treatment plans
• Can identify underlying issues not detectable through other diagnostic methods

Recovery

• Patients can generally resume normal activities immediately after the procedure.
• Some mild soreness or voice changes may occur but should resolve within a day or two.
• Follow-up appointments may be scheduled to discuss results and next steps.

Alternatives

• Laryngoscopy: A visual examination of the larynx using a scope.
• Stroboscopy: A technique using a strobe light to visualize vocal cord vibrations.
• Voice therapy: Non-invasive treatment for certain voice disorders.
• Each alternative has its own pros and cons regarding invasiveness, cost, and the type of information provided.

Patient Experience

During the procedure, patients might feel a mild prick or pressure from the needle insertions. Local anesthesia can help reduce discomfort. Post-procedure, patients might experience temporary soreness or slight bruising but this is typically minimal and resolves quickly. Pain management involves over-the-counter pain relievers if necessary, and patients are encouraged to rest their voice and stay hydrated.