Electromyogram (EMG)
Electromyogram (EMG) is a diagnostic study that provides information about the integrity of the muscles and the nerves in the body. Laryngeal electromyogram (LEMG), of course, limits the study to muscles and nerves of the larynx. Intense visual analysis of the larynx can clearly show the neurological status of three major muscles of the larynx.
Our physicians are proficient in LEMG and used it much more often before discovering the visual correlates of various laryngeal neuropathies. They continue to use LEMG frequently, however, to perform Botox™ injections for spasmodic dysphonia. In this procedure, a very small, sterile disposable needle is inserted into various muscles of the larynx. Then, using an amplifier, loudspeaker, microprocessor, and other high tech equipment, the examiner may see and/or hear how the laryngeal muscles and nerves are working and/or determine the best location for Botox™ injection.
In-Office Injection for R-CPD EMG-Guidance Compared to O.R. Esophagoscopy
Inability to burp—also known as retrograde cricopharyngeus dysfunction (R-CPD)—causes daily misery for thousands around the world. Thankfully, awareness and availability of treatment of this condition are growing around the world. The often-permanent solution is botulinum toxin (“Botox”) injection into the malfunctioning cricopharyngeus muscle (UES).
There are two main approaches: one performed under brief general anesthesia through the mouth in an operating room, and another done in a clinic setting by injecting through the front or side of the lower neck using EMG (electromyographic) guidance with partial local anesthesia.
In this video, Dr. Bastian explains both techniques, with a special focus on the EMG-guided office procedure.
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