A retrospective review was conducted of five patients presenting to the Otorhinolaryngology Head and Neck Surgery Department at Guy's and St Thomas' NHS Foundation Trust Hospital between 2000 and 2009. [ncbi.nlm.nih.gov]

• Fatigue

  Transient and definitive hypoparathyroidism, pain and fatigue scores, nausea, and the number of vomiting episodes were also registered. [ncbi.nlm.nih.gov]

  Patients with this pathology often complain of physical fatigue resulting from the increased effort to produce voice and the breathlessness associated with phonation. [bbivar.com]

  Some terms which may be used to describe a voice change are: breathy, harsh, tremulous, weak, reduced to a whisper, or vocal fatigue (voice deteriorates with use). [ 1 ] NB: any patient with unexplained hoarseness persisting >3 weeks requires investigation [patient.info]

  The duration of convalescence, after non complicated thyroid operation, may depend on several factors of which pain and fatigue are the most important. Nausea and vomiting occur mainly on the day of operation. [clinicaltrials.gov]

• Swelling

  The objectives of this study were to examine the differential palsy rates between the left and right RLNs, and the role of intraoperative nerve swelling as a risk factor of postoperative palsy. [ncbi.nlm.nih.gov]

  There was a mild soft tissue swelling anterior to the left sternocleidomastoid muscle with inspection and she had tenderness on the same region during palpation. [austinpublishinggroup.com]

  They can sustain damage anywhere along their pathway to the larynx as a result of either direct injury or from compression sustained as a result of swelling or the growth of a cyst/tumour. [britishvoiceassociation.org.uk]

• Hoarseness

  Resolution of hoarseness was approximately 70% in those with preoperative hoarseness. [ncbi.nlm.nih.gov]

• Cough

  Effective closure of the glottis was then possible, permitting an adequate cough, adequate clearing of the bronchial tree and minimising the risk of aspiration. [ncbi.nlm.nih.gov]

  Individuals with vocal cord paralysis may find the effectiveness of coughing, swallowing or sneezing in removing laryngeal area waste is undermined reduced vocal cord mobility. [medicalnewstoday.com]

  The glottic closure that allows a forceful cough is also compromised and thus a weak, unsuccessful cough is often reported by patients. [emedicine.medscape.com]

  Inability to cough: due to inability of V.C. to meet which results in retention of secretions in the chest. -Bronchopneumonia- due to repeated aspirations & retention of secretions. 27. Treatment: 1. Tracheostomy 2. Epiglottopexy 3. [slideshare.net]

  Healthy function of this nerve is needed for breathing, speaking, coughing, and swallowing. The RLN goes into the chest cavity and curves back into the neck until it reaches your voice box. [entnet.org]

• Stridor

  Mediastinal and hilar lymph node enlargement in such patients may distract clinicians from considering alternative causes of recurrent laryngeal nerve palsy, with potential ensuing severe or even life-threatening stridor. [ncbi.nlm.nih.gov]

  Hypocalcaemic stridor and infantile nutritional rickets. BMJ 1995;310(6971):48-9. Srivastava A, Ravindran V. Stridor secondary to hypocalcaemia in the elderly: an unusual presentation. Eur J Intern Med 2008;19(3):219-20. Epub 2007 Sep 19. [signavitae.com]

  • Clinical features : - Dyspnoea - Stridor 21. [slideshare.net]

  Symptoms include respiratory distress with stridor. The situation often necessitates emergent reintubation or tracheostomy. Keyword history 75%/2014 64%/2011 Sources Atlee: Complications in Anesthesia, 2nd ed. 2006. Chapter 204. [openanesthesia.org]

  ) tobacco use ( Z72.0 ) Diseases of the respiratory system J38 ICD-10-CM Diagnosis Code J38 Diseases of vocal cords and larynx, not elsewhere classified 2016 2017 2018 2019 Non-Billable/Non-Specific Code Type 1 Excludes congenital laryngeal stridor [icd10data.com]

• Sore Throat

  A 66-year-old female presented to a dental clinic with gingivitis and sore throat. Due to moderate periodontitis, her left first upper molar was extracted. [jstage.jst.go.jp]

  ENT specialists treat sore throat, infections, gastroesophageal reflux disease (GERD), throat tumors, airway and vocal cord disorders, and more. [entnet.org]

  Other ENT symptoms - dysphagia, aspiration, throat or ear pain, nasal blockage. Smoking, alcohol. [patient.info]

  This technique is inaccurate and results in cuff overinflation, 19 which can lead to tracheal mucosal ischemia and postoperative sore throat. 20 As a consequence of these findings, we are revising our institutional practice. [anesthesiology.pubs.asahq.org]

  […] that innervates the posterior cricoarytenoid and interarytenoid muscles, or inflammatory spasm of the interarytenoid muscles themselves. 43 Operation type and duration A recent study showed a statistically significant difference in the incidence of sore [hormones.gr]

• Laryngeal Disease

  Thyroid Neoplasms Vocal Cord Paralysis Endocrine System Diseases Endocrine Gland Neoplasms Neoplasms by Site Head and Neck Neoplasms Laryngeal Diseases Respiratory Tract Diseases Otorhinolaryngologic Diseases Vagus Nerve Diseases Cranial Nerve Diseases [clinicaltrials.gov]

• Gagging

  […] solids or liquids, the patient might choke (including saliva sometimes) While speaking, the sufferer may have to catch their breath more often than usual Voice volume may be affected - the patient may not be able to raise their voice Pharyngeal reflex (gag [medicalnewstoday.com]

  These include uvular deviation, loss of gag reflex, and atrophy of the soft palate and superior constrictor muscle. [ajnr.org]

Treatment was initiated with methimazole, with near complete remission of her vocal cord paralysis within 3 months. [ncbi.nlm.nih.gov]

Ten patients (52.6{\%}) required treatment for RLNP-6 required medical therapy (steroids), 1 interventional treatment (injection laryngoplasty), and 3 conservative therapy (speech therapy). [scholars.northwestern.edu]

[…] this present study is to define the significance of recurrent laryngeal nerve palsy (RLNP) detected before surgery for thyroid diseases with regard to the incidence of malignancy, histopathologic distribution, extrathyroidal invasion, management, and prognosis [ncbi.nlm.nih.gov]

Conclusions: Importantly, hoarseness second ary to laryngeal nerve compression in cardiovascular disease may correlate with a poorer prognosis, i.e ., in thoracic aortic aneurysms and mitral valvestenosis. [scirp.org]

PMID: 9339803 Superior laryngeal nerve injury: effects, clinical findings, prognosis, and management options. Orestes MI, Chhetri DK. Orestes MI, et al. Curr Opin Otolaryngol Head Neck Surg. 2014 Dec;22(6):439-43. doi: 10.1097/MOO.0000000000000097. [pubmed.ncbi.nlm.nih.gov]

Electromyelography (EMG) can be used to determine the prognosis of RLN recovery, even if a temporary injection has occurred. [emedicine.medscape.com]

It has been shown that the cricothyroid muscle does not influence the functional prognosis or the position of the vocal fold in recurrent nerve paralysis ( 6 ). [academic.oup.com]

Etiology Vocal cord paralysis may result from lesions at the nucleus ambiguus, its supranuclear tracts, the main trunk of the vagus, or the recurrent laryngeal nerves. [merckmanuals.com]

Etiology See the list below: Surgical iatrogenic injuries resulting in vocal fold paralysis include thyroid surgery, anterior cervical disc surgery, carotid surgery, or chest surgery. [emedicine.medscape.com]

Etiology superior thoracic masses, e.g. lung cancer (most common 7 ), aortic pathologies (e.g. thoracic aortic aneurysm ), thyroid cancer, laryngeal cancer 6,7 masses affecting the vagus nerve, e.g. jugular foramen masses, carotid body tumors surgical [radiopaedia.org]

After resolution of acute laryngeal findings, etiology is distinguished from two major causes of this condition. [austinpublishinggroup.com]

Etiology and consequences. Chirurg 1998;69(9):951-6. Dionigi G, Boni L, Rovera F, Rausei S, Castelnuovo P, Dionigi R. Postoperative laryngoscopy in thyroid surgery: proper timing to detect recurrent laryngeal nerve injury. [signavitae.com]

BRLNP is rare, occurring in approx. 0.2% of thyroidectomies for benign thyroid affections. (2) Epidemiological data on late BRLNP after thyroidectomy is spares. [signavitae.com]

Epidemiology A retrospective analysis of data from a large American claims database found that of almost 55 million individuals, 536,943 patients (ages 0 to >65 years) were given a dysphonia diagnosis (point prevalence rate of 0.98%). [ 3 ] One study [patient.info]

Previous literature indicates the underlying pathophysiology for delayed onset of RLNP may be small vessel ischemia, vasospasm, or viral resurgence that leads to recurrent laryngeal nerve dysfunction. [ncbi.nlm.nih.gov]

Pathophysiology The recurrent laryngeal nerve is responsible for both abduction and adduction of the vocal fold. [emedicine.medscape.com]

Pathophysiology There are several different mechanisms of nerve injury and means of nerve regrowth ( 7 ). [academic.oup.com]

One possible pathophysiological explanation regarding this clinical presentation could be the compression of the nerve, specifically the anterior branch of RLN, 45 between an inflated endotracheal tube cuff and the overlying thyroid cartilage, especially [hormones.gr]

We aim to evaluate the role of intraoperative corticosteroids in preventing or treating postoperative RLNP. [ncbi.nlm.nih.gov]

References Apfelbaum RI, Kriskovich MD, Haller JR: On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. [anesthesiology.pubs.asahq.org]

It prevents something from entering the throat except as part of normal swallowing and helps prevent choking. Possible complications Breathing - if symptoms are severe enough the patient can have serious, life-threatening breathing problems. [medicalnewstoday.com]

Abstract The aim of this study is to evaluate the effect of corticosteroids in preventing or treating postoperative recurrent laryngeal nerve palsy (RLNP) after total thyroidectomy. [aamj.eg.net]

CONCLUSION: This case highlights hypoglossal and recurrent laryngeal nerve palsy occurring without direct transection during surgery, a potentially preventable complication with careful attention to reducing compression of the lateral tongue base and [neurology.org]