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Bilateral Vocal Cord Paralysis

True Vocal Cords Impaired Mobility Bilateral Cord Paralysis


Presentation

  • We describe what appears to be the first case in the medical literature of sarcoidosis presenting as isolated, bilateral true vocal cord paralysis resulting from compressive bilateral mediastinal adenopathy.[ncbi.nlm.nih.gov]
Excessive Daytime Sleepiness
  • She had been referred with a history of high-pitched snoring, apnea witnessed by her spouse, and excessive daytime sleepiness for the last 5 years.[ncbi.nlm.nih.gov]
Down Syndrome
  • Down syndrome, 22q deletion syndrome, Robinow's syndrome and cerebro-oculo-facio-skeletal syndrome, no reports of Moebius syndrome with CBVCP were found in the literature. CBVCP is often associated with central nervous system abnormalities.[ncbi.nlm.nih.gov]
Stridor
  • We report a case of bilateral vocal cord paralysis leading to significant stridor in a patient with atypical parkinsonism (probable MSA).[ncbi.nlm.nih.gov]
Dyspnea
  • Management of severe dyspnea caused by association of these two complications of thyroidectomy means a great therapeutic challenge.[ncbi.nlm.nih.gov]
Laryngeal Disease
  • 著者 森智治, 長谷川功, 邑田悟, 趙晃済, 武信洋平, 大鶴繁, 佐藤格夫, 西山慶, 鈴木崇生, 小池薫 cw 認知症, ニンチショウ, dementia, 062282, *, 脳幹神経節疾患, ノウカンシンケイセツシッカン, basal ganglia disease, 055599, 喉頭疾患, コウトウシッカン, laryngeal disease, 054514, 麻痺性疾患, マヒセイシッカン, paralytic disease, 039774, 合併症, ガッペイショウ,[togodb.dbcls.jp]
  • Diseases Otorhinolaryngologic Diseases Vagus Nerve Diseases Cranial Nerve Diseases[clinicaltrials.gov]
  • Ultrasound has become a very important widely used diagnostic tool for the diagnosis of head and neck diseases; however, ultrasound has rarely been used in the diagnosis of laryngeal diseases related to the visualization of endolaryngeal structures [9[ejo.eg.net]
Loud Snoring
  • The RDI, DI, mean saturation and percentage of snoring, loud snoring and sleep without snoring were estimated and compared pre- and postoperatively. The results were compared by the Student's t-test for dependent values.[ncbi.nlm.nih.gov]
Hypotension
  • We present a case of a 72-year-old man who had a 2-year history of orthostatic hypotension, neurogenic bladder, impotence, anhydrosis, and extremity weakness and paresthesias.[ncbi.nlm.nih.gov]
Orthostatic Hypotension
  • We present a case of a 72-year-old man who had a 2-year history of orthostatic hypotension, neurogenic bladder, impotence, anhydrosis, and extremity weakness and paresthesias.[ncbi.nlm.nih.gov]
Hand Muscle Weakness
  • The patient, a 37-year-old male, was paraplegic, had bilateral intrinsic hand muscle weakness and sphincter involvement following a whiplash cervical spinal injury. A C5-C6 ACD/F for traumatic C5-C6 disc prolapse was performed.[ncbi.nlm.nih.gov]
Osteophyte
  • We report the MR and CT findings of a case of bilateral vocal cord paralysis caused by cervical spinal osteophytes compressing the recurrent laryngeal nerves.[ncbi.nlm.nih.gov]
Neck Mass
  • Fiberoptic bronchoscopy demonstrated bilateral vocal cord paralysis, and a CT scan of the neck demonstrated a right neck mass. On surgical exploration, the mass was found extending from the thyroid gland and was identified as benign thyroid tissue.[ncbi.nlm.nih.gov]
Somnolence
  • Within minutes, fever and somnolence developed, followed by progressive respiratory distress and stridor, without generalized weakness. The child's condition progressed to complete airway obstruction, and intubation was necessary.[ncbi.nlm.nih.gov]
Bradykinesia
  • Patients can struggle to manage a tracheostomy due to the tremor and bradykinesia associated with their parkinsonism.[ncbi.nlm.nih.gov]
Neglect
  • Vocal cord paralysis is a rare and often neglected condition, contributing to repeated episodes of acute respiratory failure. Flow-volume loop is a useful tool when symptoms are suggestive of upper airway obstruction.[ncbi.nlm.nih.gov]
Dysarthria
  • In terms of bulbar palsy as a presenting symptom, dysarthria and dysphagia are of common features. Hoarseness, however, is an initial symptom of ALS in only a small number of patients.[ncbi.nlm.nih.gov]

Workup

  • On further workup he was diagnosed with hypothyroidism. Genetic workup supported the diagnosis of Williams-Beuren syndrome. We report here a case with an unusual clinical presentation.[ncbi.nlm.nih.gov]
  • In particular, this workup must include topical anesthesia to the larynx so as to enable an extremely close visualization of the posterior commissure and subglottis, which may uncover evidence of scarring.[laryngopedia.com]
Hypercapnia
  • Treatment with nocturnal inspiratory positive airway pressure via nasal mask improved symptoms and reduced hypercapnia.[ncbi.nlm.nih.gov]
Borrelia Burgdorferi
  • The diagnosis of borreliosis was made by detection of IgM and IgG antibodies against Borrelia burgdorferi on enzyme immunoassay and Western blot.[ncbi.nlm.nih.gov]
Streptococcus Pneumoniae
  • Laboratory evaluation confirmed the diagnosis of meningitis due to Streptococcus pneumoniae. He was intubated on arrival and required 4 days of ventilatory support.[ncbi.nlm.nih.gov]
Occipital Encephalocele
  • […] large subtorcular occipital encephalocele in neonate carries higher risk of associated hindbrain anomalies and secondary process for neurological deterioration which predict the surgical outcomes and long-term prognosis.[ncbi.nlm.nih.gov]

Treatment

  • OBJECTIVE: To evaluate long-term results of surgical treatment for bilateral vocal cord paralysis using objective and subjective measures of breathing and voice quality. DESIGN: Prospective cross-sectional case series.[ncbi.nlm.nih.gov]

Prognosis

  • […] large subtorcular occipital encephalocele in neonate carries higher risk of associated hindbrain anomalies and secondary process for neurological deterioration which predict the surgical outcomes and long-term prognosis.[ncbi.nlm.nih.gov]
  • The role of laryngeal electromyography (EMG) in contributing to the diagnosis and prognosis of vocal cord immobility in children has been debated, in part because the standard awake, percutaneous technique used in adults is not practical.[entokey.com]
  • The prognosis and management of idiopathic vocal cord paralysis. Clinical Otolaryngology, 14 (3), 247-250. Woo, P. (2010). Stroboscopy. San Diego, EEUU: Plural Publishing. Woo, P., Colton, R., Brewer, D. & Casper, J. (1991).[revistas.iberoamericana.edu.co]

Etiology

  • There was no obvious cause for the paralysis and possible etiological factors are discussed. Overextension of the neck during intubation is suspected of being the etiological agent causing stretching of both the vagus nerves.[ncbi.nlm.nih.gov]
  • Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope. 2007 Oct;117(10):1864-70. [CrossRef] [PubMed] Cite as: Van Hook CJ, Warner B, Taylor A, Gould J. Medical image of the week: bilateral vocal cord paralysis.[swjpcc.com]

Epidemiology

  • Post-surgical intervention is warranted to restore laryngeal muscle strength, agility and coordination. [20] Epidemiology [ edit ] Due to the complex and controversial nature of this condition, [3] epidemiological (incidence) reports vary significantly[en.wikipedia.org]
  • Tracheostomy: epidemiology, indications, timing, technique, and outcomes. Respir Care. 2014 Jun;59(6):895–915. 14. Newman MH, Work WP. Arytenoidectomy revisited. Laryngoscope. 1976 Jun;86(6):840–9. 15. Woodman D.[e-ceo.org]
Sex distribution
Age distribution

Pathophysiology

  • However, the pathophysiology of CBVCP is unknown and further investigations into the etiology of Moebius syndrome are required.[ncbi.nlm.nih.gov]
  • Reisert PM (1996) Pathophysiology and clinical aspects of myxedema. Z Lymphol 20:6–10 PubMed Google Scholar 26. Lichtenberger G (2007) A new ligature-suture technique and instrument to control difficult pharyngeal and laryngeal hemorrhage.[link.springer.com]
  • Negative pressure pulmonary edema revisited: Pathophysiology and review of management. Saudi J Anaesthesia [Internet]. 2011; 5: 308-13. Krodel DJ, Bittner E a, Abdulnour R-EE, Brown RH, Eikermann M.[revistas.asoneumocito.org]
  • Pathophysiology Although a comprehensive discussion of each of the causes is beyond the scope of this article, some principles should be emphasized.[emedicine.medscape.com]
  • Bilateral vocal fold motion impairment: pathophysiology and management by transverse cordotomy. Ann Otol Rhinol Laryngol 1991; 100 (Pt 1):717-721. 8. Laccourreye O, Escovar M, Gerhardt J, et al.[ejo.eg.net]

Prevention

  • Early decompression may prevent permanent recurrent laryngeal nerve injury and airway obstruction.[ncbi.nlm.nih.gov]

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