To the Editor We have a few comments in response to the recent article by Wang et al1: (1) the effectiveness of using laryngeal electromyography guidance (LEMG) for injection augmentation, (2) the location of the hyaluronic acid (HA) injection, and (3) the assumption that laryngoscopic guidance is no longer necessary.
Blitzer et al2 and others have described the use of LEMG as a qualitative examination to determine the function of laryngeal musculature.2 LEMG is therefore useful if the injection was meant to be in an active vocal cord as in onabotulinum toxin for spasmodic dysphonia. However, if there is absolutely no electrical activity within the muscle,1 then the LEMG would be of less use.
Tang CG, Mor N, Blitzer A. The Effectiveness of Using Laryngeal Electromyography Guidelines for Injection Augmentation. JAMA Otolaryngol Head Neck Surg. 2015;141(11):1030. doi:10.1001/jamaoto.2015.2413