| Objective 1. To determine the clinical evaluation role of lai~geal electromyography (LEMG) in the recurrent laiyngeal nerve (RLN) injury and regeneration after thyroid surgery. 2. To predict recovery of unilateral vocal cord paralysis (UVCP) after thyroid surgery using LEMG. 3. To study the display of different types injuries of RLN in LEMG. Methods 1. All cases were divided into four groups according to the interval of LEMG after onset, which were group one (2 months shorter, n=6), group two (2 to 4 months, nl 1), group three (4 to 6 months, n) and group four (6 months longer, n12). The characteristics of LEMG of 38 cases with UVCP after thyroid surgery were assessed. We examined and analyzed the waveform morphology and the amplitude of LEMG during voluntary tasks and the highest evoked compound muscular active potential (CMAP) amplitude of thyroaiytenoid muscle (TA). 2. The laryngoscopy was performed to observe the recovery of vocal cord mobility in 32 patients with UVCP after thyroid surgery. The characteristics of LEMG of the recovered patients and the nonrecovered patients were assessed, respectively. 3. Ten patients (13 sides) with VCP after thyroid surgery were studied by LEMG before the operations in which the RLNs were explored. The condition of RLN injury and internal laryngeal muscles was observed and recorded during the operation. Results 1. ElecUical silence was recorded in 2 cases in group one. No electrical silence was found in the other groups. Only when a case presented the waveform morphology of either mixed pattern or interference pattern might the CMAP be evoked out The mean amplitude value of LEMG for the paralyzed TA from group one to group four was (28.2±28. 1)%, (54.2±30.5)%, (53.4±24.4)% and (49.6±0.0)% respectively. No significant difference was observed between each two groups (P>O.05). The highest evoked CMAP mean amplitude value was (0.5±2)%, (22.6±26.0)%, (24.9± 19.0)% and (23.0±19.2)% respectively. The highest evoked CMAP mean amplitude value in groupore was aignhaItl foWer than that of the othere bo groUPS (P<0.05), bot no pe bowas for bo eacn two mp orthe bo be pe op.05). 2. ^s rar as po twoand po be were COnCemed, the mean aInW valu of LEMG for the ~ TA for thereco- Patien the5) ana the bo Patients forl l) was (65.0t22.9)% and ew.0t28.2)%wi ho sithe bo was for boen ha op.05). ffe highch evotew aInPlitud vta was (54.4l l2.7)% anu (15.4f l5.6)% wt spo bowas observed bo theIn (P<0.0l). A POsthe Prognosis for ~ recOVny was indicated whenthe bo Pattem pesented anu the higheSt evoked mp mean amPlitud was higher bo33AN. On the basis of thes criterion our OVed cond Prognoaic the was 88%. When the inwtbo onset tO LEMG recothe was fonger than 6 months, none of theSe Patients had tri of vocalcoul mObili bo were the OUtCOIneS of LEMG. 3. When RLN exPled wi were-- in the l0 Patien (13 sides with VCp after thpoid mp the severe injuries of RLN werefoUn. The tws of injuries were listed as cut ligallon and adheson The tw ofinwt ~mUSCes wasn't very sem. When the M of a ~ was cut off or lwi the wavefOnnInOpegy of LEMG was reCOds ds singl Pattem and no CMAP or ed Pattem and WeakM No electrical silence or boe Patw was shOWn. When the ns was adhed to otherhssue, the M morphlogy of MG wt M M H or intetwe Patw andthe CM coul be eVdri out bot the CM aInPM W was very H NO electrical silenCeand singl pe was for.ConclusiOn l. LEMG can eValuat the degIeeS of RLN injuries and --. 2. TheWavefOnn InOtw of LEMG and the CMAP aInPlitud are valuab in detenninin PrognOsis. 3.the the RLN was cUt oK the wavefOnn mOrpboOgy of mp ed't N electrital silence andthe wed CMAP ~ be eVoked out in som cases. When the vocai coul mobfy Wouldn't recoverby our W Non. the H should be W as...
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