scholarly journals Photodocumentation of the Development of Type I Posterior Glottic Stenosis after Intubation Injury

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Nelson Scott Howard ◽  
Travis L. Shiba ◽  
Julianna E. Pesce ◽  
Dinesh K. Chhetri
Keyword(s):  
Vocal Fold ◽  
Mucosal Injury ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Type I ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Vocal Fold Immobility ◽  
Serial Images ◽  
Bilateral Vocal Fold Immobility ◽  
Posterior Glottis

Bilateral vocal fold immobility may result from bilateral recurrent laryngeal nerve paralysis or physiologic insults to the airway such as glottic scars. The progression of mucosal injury to granulation tissue, and then posterior glottis stenosis, is an accepted theory but has not been photodocumented. This paper presents serial images from common postintubation injury to less common posterior glottic stenosis with interarytenoid synechia.

Effect of Vocal Fold Augmentation on Laryngeal Vibration in Simulated Recurrent Laryngeal Nerve Paralysis: A Study of Teflon and Phonogel

1989 ◽  
Vol 98 (3) ◽  
pp. 220-227 ◽  
Author(s):  
Terrence K. Trapp ◽  
Gerald S. Berke ◽  
David G. Hanson ◽  
Theodore S. Bell ◽  
Paul H. Ward
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Acoustic Analysis ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Paralysis ◽  
Advantages And Disadvantages ◽  
Laryngeal Nerve Paralysis ◽  
Bovine Collagen ◽  
Vocal Fold Augmentation

Flaccid laryngeal nerve paralysis may be treated by vocal fold augmentation with Teflon injection, which is successful to various degrees depending on the subjective interpretation of the patient or clinician. A new material, Phonogel, consisting of cross-linked bovine collagen, is available but not approved for human use in this area. Ten dogs were submitted to videostroboscopy, photoglottography, electroglottography, and acoustic analysis in the normal state, with simulated recurrent laryngeal nerve paralysis, and with injection of either Teflon or Phonogel. A statistical comparison and the advantages and disadvantages of each material are discussed in relation to this study and its clinical use.

Coordinated Electrical Pacing of Vocal Cord Abductors in Recurrent Laryngeal Nerve Paralysis

1985 ◽  
Vol 93 (5) ◽  
pp. 634-638 ◽  
Author(s):  
Randal A. Otto ◽  
Jerry Templer ◽  
William Davis ◽  
David Homeyer ◽  
Mark Stroble
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Electromyographic Activity ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Alternative Approach ◽  
Posterior Cricoarytenoid ◽  
Electrical Pacing

Electrodes were placed into the posterior cricoarytenoid and diaphragmatic muscles of five tracheostomized dogs. With the use of a sensor that would selectively detect diaphragmatic electromyographic activity, this activity served as a trigger and was amplified and interfaced with a muscle stimulator attached to electrodes placed in the posterior cricoarytenoid muscles. In all animals obvious physiologic synchrony of vocal fold abduction and a reduction of the negative inspiratory intratracheal pressure were observed during electrical pacing. This represents a preliminary step in the development of an alternative approach to the patient with bilateral recurrent laryngeal nerve paralysis.

Impact of Vocal Cord Paralysis on Cricoarytenoid Joint

2002 ◽  
Vol 111 (10) ◽  
pp. 896-901 ◽  
Author(s):  
Andreas Müller ◽  
Friedrich P. Paulsen
Keyword(s):  
Articular Cartilage ◽  
Vocal Fold ◽  
Structural Changes ◽  
Laryngeal Nerve ◽  
Joint Surface ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Adult Humans ◽  
Cricoarytenoid Joint

To demonstrate structural changes in the cricoarytenoid joint after recurrent laryngeal nerve paralysis, we performed a laboratory investigation of fixed arytenoid cartilages from adult humans obtained during laser surgical arytenoidectomy in cases of bilateral vocal fold paralysis, analyzing the articular cartilage, the joint capsule, and the attached laryngeal musculature. Ten arytenoid cartilages from adult humans were studied by means of histology, as well as scanning and transmission electron microscopy. After long-standing denervation (>6 months), all arytenoid cartilages showed degenerative changes in their joint surface structure at various levels of intensity. The articular surface revealed fibrillation in some places, demasking of collagen fibrils next to the joint surface, and formation of chondrocyte clusters near the joint surface. All specimens also showed muscle atrophy. We conclude that long-standing recurrent laryngeal nerve paralysis does not result in ankylosis of the cricoarytenoid joint, as assumed, but the articular cartilage undergoes structural changes comparable to those in osteoarthritis. Structural changes in the articular cartilage and in the surrounding musculature hamper efforts at joint function recovery, as do procedures aiming solely at either medialization or lateralization of the vocal fold.

scholarly journals Partial Recurrent Laryngeal Nerve Paralysis or Paresis? In Search for the Accurate Diagnosis

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Alexander Delides ◽  
Panagiotis Kokotis ◽  
Pavlos Maragoudakis
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
Accurate Diagnosis ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Laryngeal Electromyography ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Partial Paralysis

“Partial paralysis” of the larynx is a term often used to describe a hypomobile vocal fold as is the term “paresis.” We present a case of a dysphonic patient with a mobility disorder of the vocal fold, for whom idiopathic “partial paralysis” was the diagnosis made after laryngeal electromyography, and discuss a proposition for a different implementation of the term.

Intracordal Injection Increases Glottic Closing Force in Recurrent Laryngeal Nerve Paralysis

1992 ◽  
Vol 107 (3) ◽  
pp. 451-456 ◽  
Author(s):  
Yasunari Iwanaga ◽  
Tadatsugu Maeyama ◽  
Toshiro Umezaki ◽  
Takemoto Shin
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Peak Pressure ◽  
Laryngeal Nerve ◽  
Control Group ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Lesion ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Closing Force

Glottic closing pressure during swallowing was measured in the cat with a catheter pressure transducer to study the effectiveness of intracordal injection in increasing glottic pressure in unilateral recurrent laryngeal nerve paralysis. Swallows were elicited by pouring water into the pharynx while the animal was under light anesthesia with ketamine. Peak pressure of the glottic closure for the control group during deglutition was 68.0 ± 10.5 mm Hg (mean ± standard deviation). Peak pressure decreased to 22.0 ± 3.6 mm Hg just after sectioning of the unilateral recurrent laryngeal nerve, and rose to 39.8 ± 8.3 mm Hg by silicon injection into the paralyzed vocal fold. In a study of chronic cases 1 month or more after unilateral recurrent laryngeal nerve section, peak pressure was 49.1 ± 23.4 mm Hg, and varied widely from 21 to 92 mm Hg because of differences in the position of the paralyzed vocal fold and the degree of compensation by the unaffected vocal fold. In the group that had the paralyzed vocal fold fixed in the median position, peak pressure was almost the same as that of the control group. When the paralyzed vocal fold was fixed in either the paramedian or lateral position, peak pressure was 33.3 ± 7.0 mm Hg. This value was significantly elevated to 45.8 ± 10.4 mm Hg by injection of silicon, though it remained lower than that of the control. These results suggest that the decrease in glottic closing force during swallowing as a result of unilateral recurrent laryngeal nerve lesion is compensated for by the unaffected vocal fold to some degree and is improved by intracordal injection.

Calcium Hydroxylapatite Paste for Vocal Rehabilitation

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P49-P49
Author(s):  
Marion B Gillespie ◽  
Jason A Curry ◽  
Thomas S Dozier
Keyword(s):  
Vocal Fold ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Vocal Rehabilitation ◽  
Nerve Paralysis ◽  
Calcium Hydroxylapatite ◽  
Laryngeal Nerve Paralysis ◽  
Operative Endoscopy ◽  
The Mean ◽  
The Voice

Objective Determine the effectiveness of calcium hydroxylapatite paste in vocal rehabilitation in routine clinical practice. Methods Retrospective series of adult patients undergoing calcium hydroxylapatite paste injection for vocal fold rehabilitiation over a 3-year period. Outcomes include change in Voice Handicap Index (VHI) scores, procedure-related complications, and need for follow-up vocal procedures. Results A total of 23 patients with an average age of 65 years underwent vocal fold rehabilitation with calcium hydroxylapatite injection performed by operative endoscopy. Indications for injection included recurrent laryngeal nerve paralysis in 17 patients and partial cordectomy defects in 6 patients. There were no observed procedure-related complications. Following injection, 17 patients (74%) had improvement in voice as measured by VHI, 4 had worsening of voice, and 2 were essectially unchanged from baseline. The mean VHI scores improved from 66 (S.D. 4.4) to 35 (S.D. 4.5) after a mean follow-up time of 2 months (p=0.00001). There was a non-significant trend toward greater improvement in the VHI scores for the paralysis group compared to the cordectomy group (p=0.09). Six patients required subsequent vocal procedures after the first injection to improve the voice, 4/6 in the cordectomy group and 2/17 in the paralysis group (p=0.02). Conclusions Calcium hydroxylapatite injection results in significantly improved vocal scores in the majority of patients. The paste was less satisfactory in patients with cordectomy defects due to poor retention of paste in the scarred vocal remnant. External medialization is usually required in these cases in order to adequately mobilize the scar to produce the volume necessary for satisfactory voice.

Vocal fold paralysis in the presence of thyroid disease: management strategies

2013 ◽  
Vol 127 (8) ◽  
pp. 768-772 ◽  
Author(s):  
F O'Duffy ◽  
C Timon
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Disease ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Benign Thyroid Disease ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Benign Thyroid

AbstractBackground:The presentation of vocal fold palsy with associated goitre has historically been considered to be due to malignancy with recurrent laryngeal nerve involvement.Method:In total, 830 consecutive patients who underwent thyroid surgery were reviewed. Patients with vocal fold paralysis and thyroid disease were examined to determine the aetiology of the paralysis.Results:Nine patients were identified with new onset vocal fold paralysis prior to thyroid surgery. Six of the patients with recurrent laryngeal nerve paralysis had benign thyroid disease, and for three of the patients the paralysis was secondary to malignancy.Conclusion:Recurrent laryngeal nerve paralysis in the presence of thyroid disease is not pathognomonic for malignancy. The current literature may underestimate the association between vocal fold paralysis and benign thyroid disease. The paper also highlights the importance of recurrent laryngeal nerve preservation in patients who present with palsy and thyroid disease; the relief of benign compression often leads to complete recovery of recurrent laryngeal nerve paralysis.

Causes of and Phonosurgical Treatment for Recurrent Laryngeal Nerve Paralysis.

2002 ◽  
Vol 53 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Eiji Yumoto ◽  
Koji Nakano ◽  
Tetsuya Nakamoto ◽  
Takahiko Yamagata
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis
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