实时超声辅助喉肌电图采用平面内轨迹视图：一项前瞻性可行性研究
Real-Time Ultrasound-Assisted Laryngeal Electromyography Using an In-Plane Trajectory View: A Prospective Feasibility Study.
文献信息
| PMID | 42971343 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yong Jae Na |
| 作者单位 | Department of Physical and Rehabilitation Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si, South Korea. |
| 期刊 | Archives of physical medicine and rehabilitation |
| SCI 分区 | Q1 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评估一种实时超声辅助喉肌电图（LEMG）方案的可行性、安全性和操作性能，该方案使用单一专用平面内轨迹视图进行针引导，无需电磁跟踪设备。
设计： 由两名医师采用相同标准化技术进行的前瞻性单臂可行性研究。
场所： 单中心大学医院康复医学科。
参与者： 连续16例成年患者（N=16；男14例，女2例；平均年龄69.5±10.9岁），因疑似神经肌肉性喉功能障碍转诊行LEMG。
干预： 在采用三个定位视图进行解剖调查后，使用单一平面内外侧斜行轨迹取样甲杓肌（TA）和环甲肌（CT）。
主要结局指标： （i）肌电图确认的肌肉取样成功；（ii）完整的实时针可视化；（iii）各结构的超声可视化率；（iv）操作相关不良事件。
结果： 共取样44块肌肉（31块TA，13块CT）。肌电图确认取样成功率为100%（44/44）。完整实时针可视化在4/31块TA肌肉（12.9%）和13/13块CT肌肉（100%）中实现；甲状软骨钙化（87.5%）是TA的主要限制因素。TA和CT肌肉可视化率为100%；杓状软骨和声带为30/32（93.8%）。44次肌肉检查中发生短暂咳嗽3次（6.8%）；均无需终止操作。未发生出血、血肿或感染。
结论： 在这一单臂队列中，使用单一专用轨迹视图的实时平面内超声辅助LEMG方案可行，并显示出良好的短期安全性特征，且使用普通超声设备、无需电磁跟踪。在甲状软骨钙化常见的老年患者中，超声主要提供轨迹引导和血管规避；肌电信号仍是定位参考。有必要开展与传统标志点法LEMG的对照研究，以确立其附加价值。
英文摘要
OBJECTIVE: To assess the feasibility, safety, and procedural performance of a real-time ultrasound-assisted laryngeal electromyography (LEMG) protocol that uses a single dedicated in-plane trajectory view for needle guidance, without electromagnetic tracking equipment.
DESIGN: Prospective single-arm feasibility study performed by two physicians using an identical standardized technique.
SETTING: Single-center university hospital, department of rehabilitation medicine.
PARTICIPANTS: Sixteen consecutive adult patients (N=16; 14 men, 2 women; mean age 69.5±10.9 years) referred for LEMG for suspected neuromuscular laryngeal dysfunction.
INTERVENTIONS: Following anatomic survey with three orientation views, a single in-plane lateral oblique trajectory was used to sample thyroarytenoid (TA) and cricothyroid (CT) muscles.
MAIN OUTCOME MEASURES: (i) Electromyography-confirmed muscle sampling success; (ii) complete real-time needle visualization; (iii) per-structure ultrasound visualization rates; and (iv) procedure-related adverse events.
RESULTS: Forty-four muscles (31 TA, 13 CT) were sampled. EMG-confirmed sampling was achieved in 100% (44/44). Complete real-time needle visualization was achieved in 4/31 TA muscles (12.9%) and 13/13 CT muscles (100%); thyroid cartilage calcification (87.5%) was the principal limiting factor for TA. TA and CT muscles were visualized in 100%; arytenoid and vocal cords in 30/32 (93.8%). Transient cough occurred in 3/44 muscle examinations (6.8%); none required termination. No bleeding, hematoma, or infection occurred.
CONCLUSIONS: A real-time, in-plane ultrasound-assisted LEMG protocol using a single dedicated trajectory view was feasible and showed a favorable short-term safety profile in this single-arm cohort, performed using commodity ultrasound equipment without electromagnetic tracking. In elderly patients with frequent thyroid cartilage calcification, ultrasound primarily provided trajectory guidance and vascular avoidance; the EMG signal remained the targeting reference. A comparative study against conventional landmark-based LEMG is warranted to establish its additive value.