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Unilateral Vocal Cord Paralysis


Presentation

  • The etiology and manner of presentation of UVCP are important prognostic indicators which should be considered when planning surgical intervention for UVCP.[ncbi.nlm.nih.gov]
Wound Infection
  • The procedure was well tolerated, with only one postoperative complication, which was a minor wound infection.[ncbi.nlm.nih.gov]
Amyloidosis
  • Other causes of recurrent laryngeal nerve injury reported include systemic lupus erythematosus, PDA, mediastinal radiation, iodine 131 therapy, amyloidosis, Charcot-Marie-Tooth disease More Details, mitochondrial disorders, porphyrias, polyarteritis nodosa[laryngologyandvoice.org]
Coarctation of the Aorta
  • The other benign lesions accounted for 17 cases, which included pulmonary tuberculosis ( n 10), colloid cyst of the thyroid ( n 1), cardiac anomalies such as coarctation of aorta ( n 1), tetralogy of Fallot ( n 1), right ventricular hypertrophy secondary[laryngologyandvoice.org]
Sputum
  • The silicon injection resulted in improvement of vocal quality, favorable clearance of sputum, and aspiration control.[ncbi.nlm.nih.gov]
Hypertension
  • […] may actually reflect Ortner's syndrome Classically: atrial enlargement causing traction on the left RLN issues (Ortner 1897) However: "Vocal cord paralysis appears to be caused by compression of the left recurrent laryngeal nerve between the enlarged hypertensive[medicine.uiowa.edu]
  • […] lesions accounted for 17 cases, which included pulmonary tuberculosis ( n 10), colloid cyst of the thyroid ( n 1), cardiac anomalies such as coarctation of aorta ( n 1), tetralogy of Fallot ( n 1), right ventricular hypertrophy secondary to pulmonary hypertension[laryngologyandvoice.org]
Hyperhidrosis
  • Abstract A 41-year-old man of ASA physical status class I was scheduled to receive the video-assisted thoracoscopic T2 sympathectomy for hyperhidrosis palmaris.[ncbi.nlm.nih.gov]

Workup

  • The patient workup included a detailed history taking, physical examination, flexible fiberoptic and stroboscopic evaluation of the larynx and imaging by computerized tomographic (CT) scan from the skull base to upper mediastinum when no obvious etiology[laryngologyandvoice.org]
  • This paper addresses the established diagnostic workup for VFI and critically evaluates the contribution of different modalities to VFI diagnosis.[ejo.eg.net]
  • Recent Findings The use of laryngeal electromyography in the workup of VFP has more recently been popularized as an adjunct in the diagnosis and prognosis for recovery.[link.springer.com]
  • This reveals that LEMG, with the cooperation of an experienced laryngologist and neurologist, is a valuable tool in the workup of patients with UVFP.[jamanetwork.com]
Ventricular Hypertrophy
  • […] to pulmonary hypertension ( n 1), left ventricular hypertrophy ( n 1), abnormal variant of azygous system ( n 1) and enlarged prevascular lymph node ( n 1).[laryngologyandvoice.org]

Treatment

  • Observation and speech therapy are the standard treatment. We describe three children with UVCP and severe aspiration who were treated with vocal cord injection.[ncbi.nlm.nih.gov]

Prognosis

  • Our findings revealed that unilateral vocal cord paralysis developing as a result of endotracheal intubation has a good prognosis, whereas that caused by tumors has a poor prognosis.[keio.pure.elsevier.com]
  • The presence of spontaneous activity indicates a poor prognosis for recovery.[jamanetwork.com]
  • Prognosis was excellent, with spontaneous recovery associated with resolution of the bleed. References 1. Daya H , Hosni A , Bejar-Solar I , Evans JN , Bailey CM . Pediatric vocal fold paralysis: a long-term retrospective study .[nature.com]
  • Temporary vocal fold injection can be used when return of recurrent laryngeal nerve function is expected or when the prognosis for recovery is unknown during the first 6 months after onset of paralysis (especially when a favorable prognosis is found on[emedicine.medscape.com]
  • The position of the paralyzed VF carries no significance with respect to the site of injury or prognosis.[ejo.eg.net]

Etiology

  • The etiology can be subdivided roughly into surgically induced, neoplastic and idiopathic paralysis. In the surgical group, thyroidectomy is the most common cause.[ncbi.nlm.nih.gov]
  • The most common etiology was idiopathic 136 (49.1%).[laryngologyandvoice.org]

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]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology The recurrent laryngeal nerve is responsible for both abduction and adduction of the vocal fold.[emedicine.medscape.com]
  • Bilateral vocal fold motion impairment: pathophysiology and management by transverse cordotomy. Ann Otol Rhinol Laryngol. 1991;100:717-21. Hans S, Grevier-Buchanan L, Laccourreye O, Brasnu D.[revistas.usal.es]
  • ., Flexible endoscopic evaluation of swallowing with sensory testing in patients with unilateral vocal fold immobility: incidence and pathophysiology of aspiration. Laryngoscope, 2005. 115(4): p. 565-9. 9. Leder, S.B. and D.A.[medichub.ro]
  • Kelchner LNStemple JCGerdeman ELe BWAdam S Etiology, pathophysiology, treatment choices, and voice results for unilateral adductor vocal fold paralysis: a 3-year retrospective. J Voice 1999;13 (4) 592- 601 PubMed Google Scholar Crossref 16.[jamanetwork.com]
  • Pathophysiology of vocal fold paralysis Patterns of injury The RLN contains 500-1000 motor axons, and all are myelinated [22] . The nerve trunk is a collection of fascicles.[ejo.eg.net]

Prevention

  • Dexamethasone was administered to prevent laryngeal edema. On completion of surgery, the pharyngeal packing with gauze was removed and the air leakage was less than immediately after the endotracheal intubation.[jaclinicalreports.springeropen.com]
  • Contemporary bench techniques can impact virus attenuation, thereby preventing the negative consequences of local proliferation, and allow the addition of potentially therapeutic genes.[intechopen.com]
  • Learn how to stay ENT healthy, prevent problems, and manage existing conditions to improve your, or a loved one’s, daily life.[entnet.org]
  • Augmentation involves injecting a paste of plasticized particles, collagen, micronized dermis, or autologous fat into the paralyzed cord, bringing the cords closer together to improve the voice and prevent aspiration.[msdmanuals.com]
  • Concomitant type I thyroplasty and thoracic operations for lung cancer: preventing respiratory complications associated with vagus or recurrent laryngeal nerve injury , J Thorac Cardiovasc Surg , 2001 , vol. 121 4 (pg. 642 - 648 ) [19] Stroboscopy a pertinent[academic.oup.com]

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