Laryngeal Electromyography: Case Studies

Review by L Flood
Middlesbrough, UK

When it is increasingly difficult to get print copies of books from publishers, for review, two from Plural proved a nice surprise. High quality hardbacks were even more welcome.

I immediately recalled my review of a similar title and authorship “Laryngeal Electromyography” printed in this journal in 2017 (1) and wondered how this would differ. The publishers claim this to be “the first-of-its-kind book to present multidisciplinary cases on the clinical application of laryngeal electromyography (LEMG), including key concepts and principles of LEMG interpretation.” and I can certainly confirm that.

There are six early and introductory chapters briefly outlining laryngeal anatomy, physiology and the role of LEMG in guiding management. A mere two-page chapter on the indications and value of LEMG, I found particularly good and its brevity very much reflects that this book is aimed at those already familiar with the technique.

So it is that, by Page 31 we are already into Chapter 7, which makes up the rest of the over 220 pages book, comprising 21 detailed and illustrated case examples with multimedia. Contrast this with the 7 case studies in the 2017 paperback. Each concentrates on one disease process, ranging through myasthenia gravis, vocal fold paresis or functional dysphonia and provides endoscopic images of videostroboscopy, acoustic analysis, many a dynamic CT and fibre-optic endoscopic evaluation of swallowing (FEES). Tables in every chapter illustrate the recordings of LEMG and, indeed, many potentials from much further afield. Just to prove to doubters that I have really read this cover to cover, I will question Case 16, where I quickly decided we were looking at Herpes Zoster, especially when we saw an auricular eruption. I was puzzled then to see it described as Herpes Simplex on page 146, but was reassured by the Discussion now blaming the Varicella Zoster Virus. This aged and retired otologist then felt smug.

There is a lot here to appeal to the laryngologist of course, but there is so much for the Neurologist and Speech and Language Therapist also. The text carries many a reference to Audio and Video links, on-line, which did initially puzzle me, as they are separated. There is a contact for any problem and the response from San Diego, was very quick and helpful. The audio links prove to be recordings of each voice disorder, but are in the Chinese language throughout (which is just fine for about 1 in 6 of the population of our planet, I do accept). The videos are of very high quality and number no less than 52, but lose something by lacking any sound, largely compensated by the description in the textbook itself.

The emphasis on Case Studies really works well and I am convinced that “dabbling” in voice disorders, without such comprehensive studies is unwise. How many otologists will approach the middle ear without a prior pure tone audiogram?

1. Flood LM. Laryngeal Electromyography 3rd ed R T Sataloff , S Mandel , Y Heman-Ackah , M Abaza. The Journal of Laryngology & Otology. 2017;131:750–750. doi:10.1017/S0022215117001293

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