Vocal fold paralysis following carotid endarterectomy

1999 ◽  
Vol 113 (5) ◽  
pp. 439-441 ◽  
Author(s):  
Fernanda I. Espinoza ◽  
Fiona B. MacGregor ◽  
Julie C. Doughty ◽  
Lynn D. Cooke
Keyword(s):  
Vagus Nerve ◽  
Carotid Endarterectomy ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Indirect Laryngoscopy ◽  
One Year ◽  
Operative Assessment

AbstractInjury to the vagus nerve or one of its branches during carotid endarterectomy (CEA) can result in vocal fold paralysis (VFP). This study assessed prospectively 73 patients undergoing CEA. A total of 76 procedures were performed in these patients over a one-year period. All patients underwent preoperative and post-operative assessment of vocal fold mobility by indirect laryngoscopy and/or flexible nasendoscopy. All patients had normal vocal fold mobility pre-operatively. Eight patients (10 per cent) complained of hoarseness after surgery and in three patients (four per cent) examination confirmed an ipsilateral VFP. This persists in all three patients at six-month follow-up. Vocal fold assessment is important in patients undergoing CEA, particularly when performing second side surgery. We recommend that patients should be informed of the risk of VFP following CEA when obtaining consent.

A Clinical Audit of the Investigation and Follow-up of Vocal Fold Paralysis at Rigshospitalet, Denmark

2019 ◽  
Vol 2 (1) ◽  
pp. 52-56
Author(s):  
Lars Iversen ◽  
Jesper Storgård Balle ◽  
Ramon Gordon Jensen
Keyword(s):  
Vocal Fold ◽  
Clinical Audit ◽  
Vocal Fold Paralysis

Arytenoidopexy for bilateral vocal fold paralysis in young children

1996 ◽  
Vol 110 (11) ◽  
pp. 1027-1030 ◽  
Author(s):  
Jean-Michel Triglia ◽  
Jean-François Belus ◽  
Richard Nicollas
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Young Children ◽  
Vocal Fold ◽  
Good Health ◽  
Vocal Fold Paralysis ◽  
Airway Compromise ◽  
Bilateral Vocal Fold Paralysis ◽  
Life Threatening

AbstractThe purpose of this retrospective study was to describe and evaluate the results of arytenoidopexy performed by the external laterocervical approach in 15 consecutive children presenting bilateral vocal fold paralysis causing life-threatening airway compromise. Mean age at the time of surgery was 20 months and mean follow-up was 42 months. At the end of follow-up all patients were in good health and did not need special care for breathing. No abduction movement has been observed on the opposite vocal fold since arytenoidopexy. One failure subsequently required arytenoidectomy. The findings of this study suggest that arytenoidopexy is an effective surgical treatment for life-threatening bilateral vocal fold paralysis in young children.

Vagus Nerve Stimulation for Intractable Seizures: One Year Follow-Up

1993 ◽  
Vol 25 (6) ◽  
pp. 362-366 ◽  
Author(s):  
Janice E. Michael ◽  
Karen Wegener ◽  
Donald W. Barnes
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Seizures ◽  
One Year

Serum levels of anti-apolipoprotein A-1 auto-antibodies and myeloperoxidase as predictors of major adverse cardiovascular events after carotid endarterectomy

2013 ◽  
Vol 109 (04) ◽  
pp. 706-715 ◽  
Author(s):  
Giovanni Spinella ◽  
Sabrina Pagano ◽  
Maria Bertolotto ◽  
Bianca Pane ◽  
Aldo Pende ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Cardiovascular Events ◽  
Predictive Accuracy ◽  
Positive Likelihood Ratio ◽  
Major Adverse Cardiovascular Events ◽  
Enzyme Linked Immunosorbent Assay ◽  
Operating Characteristics ◽  
Apolipoprotein A ◽  
One Year

SummaryWe aimed at challenging the prognostic accuracies of myeloperoxidase (MPO) and antibodies anti-apolipoprotein A-1 (anti-apoA-1 IgG), alone or in combination, for major adverse cardiovascular events (MACE) prediction, one year after carotid endarterectomy (CEA). In this prospective single centre study, 178 patients undergoing elective CEA were included. Serum anti-apoA-1 IgG and MPO were assessed by enzyme-linked immunosorbent assay prior to the surgery. Post-hoc determination of the MPO cut-off was performed by receiver operating characteristics (ROC) analyses. MACE was defined by the occurrence of fatal or non-fatal acute coronary syndromes or stroke during one year follow-up. Prognostic accuracy of anti-apoA-1 IgG was assessed by ROC curve analyses, survival analyses and reclassification statistics. During follow-up, 5% (9/178) of patients presented a MACE, and 29% (52/178) were positive for anti-apoA-1 IgG. Patients with MACE had higher median MPO and anti-apoA-1 IgG levels at admission (p=0.01), but no difference for the 10-year global Framingham risk score (FRS) was observed (p=0.22). ROC analyses indicated that both MPO and anti-apoA-1 IgG were significant predictors of subsequent MACE (area under the curve [AUC]: 0.75, 95% confidence interval [95%CI]: 0.61–0.89, p=0.01; and 0.74, 95%CI: 0.59–90; p=0.01), but combining anti-apoA-1 IgG positivity and MPO>857 ng/ml displayed the best predictive accuracy (AUC: 0.78, 95%CI: 0.65–0.91; p=0.007). It was associated with a poorer MACE-free survival (98.2% vs. 57.1%; p<0.001, LogRank), with a positive likelihood ratio of 13.67, and provided incremental predictive ability over FRS. In conclusion, combining the assessment of anti-apoA-1 IgG and MPO appears as a promising risk stratification tool in patients with severe carotid stenosis.

Results of Fascial Augmentation in Unilateral Vocal Fold Paralysis

2002 ◽  
Vol 111 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Petri Reijonen ◽  
Sari Lehikoinen-Söderlund ◽  
Heikki Rihkanen
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Inexpensive Method ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation

The objective of this study was to evaluate the effects on voice quality of augmentation by injection of minced fascia in patients with unilateral vocal fold paralysis. Preoperative and postoperative voice samples from 14 patients (6 men and 8 women; mean age, 59 years) were analyzed by computerized acoustic analysis and blinded perceptual evaluation. Statistically significant improvements were seen in perturbation measurements (jitter and shimmer), noise-to-harmonics ratio, and maximum phonation time. A panel of evaluators rated 10 of the 14 postoperative voices as normal or near-normal. Injection laryngoplasty with minced fascia offers a new, effective, well-tolerated, and inexpensive method to medialize a paralyzed vocal fold. The graft seems to survive well, as indicated by good vocal results with a follow-up ranging from 5 to 32 months.

Mesenchymal chondrosarcoma of the vagus nerve

2002 ◽  
Vol 116 (8) ◽  
pp. 644-646 ◽  
Author(s):  
W. Jamal ◽  
P. Rhys Evans ◽  
M. N. Sheppard
Keyword(s):  
Vagus Nerve ◽  
Current Literature ◽  
Vocal Fold ◽  
Malignant Neoplasm ◽  
Vocal Fold Paralysis ◽  
Mesenchymal Chondrosarcoma ◽  
Age Group ◽  
Clinicopathologic Features ◽  
The Right

Mesenchymal chondrosarcoma is a rare, aggressive, malignant neoplasm, which arises from extraskeletal sites in 30–40 per cent of cases. It is extremely rare in children. We present a novel case of childhood mesenchymal chondsarcoma arising from the vagus nerve in the neck, resulting in paralysis of the right vocal fold. The clinicopathologic features and management of this case are described along with a brief discussion on the aetiology of vocal fold paralysis in this age group. Current literature on extraskeletal presentation of mesenchymal chondrosarcoma is reviewed.

Bilateral vocal fold Paralysis in infants: tracheostomy or not?

1994 ◽  
Vol 108 (4) ◽  
pp. 329-331 ◽  
Author(s):  
G. E. Murty ◽  
C. Shinkwin ◽  
K. P. Gibbin
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
The Past ◽  
Bilateral Vocal Fold Paralysis ◽  
One Year

AbstractTracheostomy has, in the past, been performed in the majority of children under one year with bilateral vocal fold paralysis. We present our experience of 11 cases over a ten-year period during which tracheostomy was avoided whenever possible. Ten cases were managed conservatively but in the youngest a tracheostomy was required. Full bilateral vocal fold mobility developed in all cases at a mean age of 11.5 months (range 5–26 months). Our experience suggests that the airway can commonly be managed expectantly without a tracheostomy.

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