{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:52:12Z","timestamp":1789577532767,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T00:00:00Z","timestamp":1605916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Applying the principles of misdirected nerve regeneration to the larynx, Roger Crumley in 1989 coined the term laryngeal synkinesis (LS) which he later (2000) classified into 4 types (type I \u2013 good voice, type II \u2013 involuntary twitches and poor voice, type III \u2013 adduction during inspiration, type IV \u2013 abduction during phonation). Neurophysiological data were not available for all LS patients at that time. The current study was undertaken to utilize and test the Crumley classification for a clinical interrater comparison and, secondly, compare <jats:italic>predicted<\/jats:italic> with <jats:italic>actual<\/jats:italic> laryngeal electromyography (LEMG) results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Descriptive study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Laryngoscopic and LEMG data of patients with unilateral vocal fold paralysis (VFP) of 6\u2009months duration or longer were combined for retrospective evaluation. Forty\u2010five data sets were available for laryngoscopic classification by two local laryngologists and by Roger Crumley. Twenty\u2010three data sets with complete thyroarytenoid (TA) and posterior cricoarytenoid (PCA) \u2013 EMG data were used to compare predicted with actual LEMG results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Local laryngologists were able to classify 24 of 45, Crumley 30 of 45 cases into one of the 4 synkinesis types. There was substantial agreement between examiners (Cohens Kappa 0.66 [<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001]). Comparison of predicted and actual LEMG data showed only moderate agreement. EMG sykinesis rates were lower in TA than in PCA and highest in Crumley type I cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Crumley classification is helpful in describing and understanding synkinesis. It does not always correlate predictably with actual LEMG data. A complete LEMG mapping of all intrinsic muscles may improve understanding of chronic VFP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 131:E1605\u2013E1610, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29275","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T14:53:23Z","timestamp":1605970403000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Crumley's Classification of Laryngeal Synkinesis: A Comparison of Laryngoscopy and Electromyography"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6806-1289","authenticated-orcid":false,"given":"Gerhard","family":"Foerster","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\/Plastic Surgery SRH Wald\u2010Klinikum Gera  Gera Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Podema","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University Hospital, Friedrich Schiller University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9671-0784","authenticated-orcid":false,"given":"Orlando","family":"Guntinas\u2010Lichius","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University Hospital, Friedrich Schiller University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger L.","family":"Crumley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery School of Medicine, University of California  Irvine 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