{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T08:28:02Z","timestamp":1787905682587,"version":"build-2784847793"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Background\/Objective<\/jats:title><jats:p>Laryngeal electromyography (LEMG) is a useful diagnostic test in the evaluation of vocal fold paralysis (VFP). This study investigates factors that can make LEMG challenging to perform.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with subacute unilateral VFP presented for LEMG were prospectively enrolled. Demographic data including BMI, previous neck surgery, and anatomic factors were collected. Patient\u2010reported pain related to the procedure was recorded on a visual analogue scale (VAS). Electromyographer and otolaryngologist recorded a consensus rating of the perceived difficulty in performing the test and confidence in using the results for clinical decision\u2010making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 111 patients (56.8% female) were enrolled between August 2015 and August 2018. The mean age was 55\u2009\u00b1\u200914\u2009years, and the average body mass index (BMI) was 28.5\u2009\u00b1\u20096.4. The mean patient\u2010reported VAS score for pain was 35\u2009\u00b1\u200924. Notably, 31.2% of the tests were considered \u201cvery easy,\u201d 32.1% were considered \u201cmildly challenging\u201d and 23.9% and 12.8% were considered \u201cmoderately challenging\u201d and \u201cextremely challenging,\u201d respectively, by the clinicians. Common factors affecting LEMG difficulty included poorly palpable surface anatomy (50.5%) and patient intolerance (15.6%). Clinicians felt confident in 76.1% of the test findings. Bivariate analyses showed that prior neck surgery is associated with elevated VAS (<jats:italic>p<\/jats:italic>\u2009=\u20090.02), but clinician\u2010perceived difficulty of performing the test is not associated with elevated VAS scores (<jats:italic>p<\/jats:italic>\u2009=\u20090.55).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Majority of LEMG tests are well tolerated by patients. Physicians reported more confidence using LEMG for clinical decision\u2010making when the test was easier to perform. Difficult surface anatomy and patient intolerance affects clinician confidence in integrating the test results with clinical care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 134:831\u2013834, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31035","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T13:29:30Z","timestamp":1694093370000},"page":"831-834","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Technical Challenges for Laryngeal Electromyography"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1064-5868","authenticated-orcid":false,"given":"R. Jun","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Munin","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Belsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery Stanford University  Stanford California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elysia","family":"Grose","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosane","family":"Nisenbaum","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Unity Health Toronto University of Toronto  Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-1086","authenticated-orcid":false,"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery, UCSF Voice &amp; Swallowing Center University of California San Francisco  San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libby J.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40136-020-00290-x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25004"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-5102-5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26390"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27078"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27262"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2015.03.009"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05360-5"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew466"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1526-5900(03)00716-8"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-7085.2003.03034.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03022623"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000000942"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31035","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T06:08:24Z","timestamp":1705903704000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,7]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/lary.31035"],"URL":"https:\/\/doi.org\/10.1002\/lary.31035","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,7]]},"assertion":[{"value":"2023-03-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}