scholarly journals A Case of Vocal Cord Paralysis and Severe Hypocalcemia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A173-A173
Author(s):  
Sandra Omozehio Iwuala ◽  
Johnathan Kirupakaran ◽  
Rhonda Trusty ◽  
Sumarah Curry ◽  
Belinda Williams ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Case Reports ◽  
Clinical Endocrinology ◽  
Deficiency Anemia ◽  
Lower Extremity Weakness ◽  
Metabolic Bone ◽  
Transplant Center ◽  
Sevelamer Carbonate ◽  
History Of

Abstract Background: Tetany is the hallmark of hypocalcemia. Vocal cord paralysis is a rare presenting symptom of hypocalcemia, especially without signs of overt tetany or seizures. Clinical case: 18 year old man with history of iron deficiency anemia and dyslipidemia presented with aphasia, right sided upper and lower extremity weakness and facial tingling for 3 days. Physical exam was notable for aphasia, pallor, positive Chvostek and Trousseau sign. Admission labs showed BUN 127 mg/dL (n 8–26 mg/dL), creatinine 12.74 mg/dL (n 0.8–2.00 mg/dL), calcium 5.2 mg/dL (n 8.5–10.5 mg/dL), magnesium (1.8–2.4 mg/dL), phosphorus 10.3 (2.4–4.8 mg/dL), alkaline phosphatase 126 (8–120 U/L), albumin 3.3 g/dL (n 3.0–5.0 g/dL), 25 OH VitD3 9.1 ng/mL (n 30–80 ng/mL), PTH 594 pg/mL (n 15–65 pg.mL), COVID 19 PCR negative. Aphasia resolved with 1 gram calcium gluconate infusion. Patient underwent emergent hemodialysis. He was placed on calcium carbonate 1500 mg oral three times daily, calcitriol 1 mcg oral twice daily, ergocalciferol 50,000 IU weekly, sevelamer carbonate 1600 mg tablet three times daily. Kidney biopsy showed membranoproliferative pattern glomerulonephritis with C3 deposits. He was discharged on hemodialysis and referred to a transplant center. Conclusion: Vocal cord paralysis is rare in adults and mostly seen in patients with pseudohypoparathyroidism caused by hypomagnesaemia.2,3 Identifying vocal cord paralysis as an atypical presentation of hypocalcemia secondary to acute kidney failure requires prompt recognition and treatment. References: 1.Shoback D, Marcus R, Bikle D. Metabolic bone disease. In: Greenspan FS, Gardner DG, editors. Basic and clinical endocrinology. 3rd ed Los Altos (CA): Lange Medical Publications; 2004. p. 3242.van Veelen, M J et al. “Hypocalcaemic laryngospasm in the emergency department.” BMJ case reports vol. 2011 bcr1120103555. 17 Feb. 2011, doi:10.1136/bcr.11.2010.35553.Guise TA, Mundy GR. Clinical review 69: evaluation of hypocalcemia in children and adults. J Clin Endocrinol Metab 1995;80:1473–8

Is Vocal Cord Assessment before Total Thyroidectomy Required for All Patients?

2019 ◽  
Vol 85 (11) ◽  
pp. 1265-1268
Author(s):  
Birkan Birben ◽  
Sabri Özden ◽  
Sadettin Er ◽  
Bariş Saylam
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Univariate Analysis ◽  
Neck Surgery ◽  
Indirect Laryngoscopy ◽  
Surgical History ◽  
History Of ◽  
Independent Variable ◽  
The Mean

We investigated whether laryngoscopy should be performed before total thyroidectomy on all patients without a history of neck surgery. A total of 2523 patients who underwent total thyroidectomy between January 1, 2013, and March 18, 2018, were retrospectively examined. Pre-operative vocal cord examination was performed on 2070 of these patients by the otorhinolaryngology department using indirect laryngoscopy. Patients with a history of neck or thyroid surgery were not included in the study. The patients were evaluated in terms of age, gender, symptom (hoarseness/dyspnea), comorbidity, surgical history, biopsy, nodule diameter, pathological diagnosis, and tracheal deviation. Preoperative vocal cord paralysis was detected in 0.8 per cent of the patients (17/2070). Four patients (23.5%) were male and 13 patients (76.5%) were female. The mean age was 62 (range, 25–82) years. Seven of the 17 patients (41%) were symptomatic, with complaints of dyspnea in five and hoarseness in two. The univariate analysis revealed that a nodule diameter >30 mm and the presence of dyspnea were associated with vocal cord damage. Furthermore, the multivariate analysis showed that dyspnea alone was an independent variable ( P = 0.011). It is recommended that preoperative vocal cord evaluation should be performed only in patients with severe symptoms, such as dyspnea.

Bilateral Vocal Cord Paralysis with Shy-Drager Syndrome

1993 ◽  
Vol 109 (5) ◽  
pp. 911-914 ◽  
Author(s):  
Rohit Bawa ◽  
Hassan H. Ramadan ◽  
Stephen J. Wetmore
Keyword(s):  
Orthostatic Hypotension ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
English Literature ◽  
System Failure ◽  
Bilateral Vocal Cord Paralysis ◽  
Vocal Cord Paresis ◽  
Median Position ◽  
History Of ◽  
Emergency Tracheotomy

Shy-Drager syndrome consists of progressive autonomic nervous system failure with Parkinson's disease-like symptoms and orthostatic hypotension. It can also result in airway compromise from bilateral vocal cord paralysis. Fewer than 30 cases of severe bilateral vocal cord paresis or paralysis associated with the Shy-Drager syndrome have been reported in the English literature. 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. Hoarseness and dyspnea with stridor developed as a result of bilateral vocal cord paralysis in the median position and required an emergency tracheotomy. This combination of symptoms resulted in the diagnosis of Shy-Drager syndrome. We present the case along with literature review of bilateral vocal cord paralysis with the Shy-Drager syndrome.

scholarly journals Unilateral Vocal Cord Paralysis Case Related to COVID-19

2021 ◽  
Author(s):  
Müge Özçelik Korkmaz ◽  
Mehmet Güven
Keyword(s):  
Vocal Cord ◽  
Peripheral Nerves ◽  
Vocal Cord Paralysis ◽  
Laryngeal Nerve ◽  
Voice Therapy ◽  
Neurologic Disease ◽  
Vascular Risk ◽  
Voice Changes ◽  
History Of ◽  
Unilateral Vocal Cord Paralysis

Abstract Introduction: Although the most common neuro-otolaryngological findings associated with COVID-19 infection are chemosensory changes, it should be known that these patients may present with different clinical findings.Case summary: We present a 57-year-old woman who developed progressive hoarseness while suffering from COVID-19 infection without a history of chronic disease or any other etiological cause. Laryngeal fiberscopy revealed left vocal cord fixed at the cadaveric position and there was 5-6 mm intraglottic gap during phonation. No other etiological cause was found in the examinations performed with detailed ear nose throat examination, neurological evaluations and imaging methods. Injection laryngoplasty was applied to the patient, and voice therapy was initiated, resulting in significant improvement in voice quality.Discussion: The mechanism of the idiopatic vocal cord paralysis remains unclear, it is suspected to be related to COVID-19 neuropathy, because the patient had no preexisting vascular risk factors or evidence of other neurologic disease on neuroimaging. Laryngeal nerve palsies may represent part of the neurologic spectrum of COVID-19.Conclusion: The possibility of the peripheral nerves damage caused by SARS-CoV-2, vocal cord paralysis should be considered when voice changes occur during COVID 19 infection.

Bilateral vocal cord paralysis in Miller Fisher syndrome/Guillain-Barre overlap syndrome and a review of previous case series

2021 ◽  
Vol 14 (1) ◽  
pp. e240386
Author(s):  
Jeeyune Bahk ◽  
Wanding Yang ◽  
Jonathan Fishman
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Case Reports ◽  
Case Series ◽  
Overlap Syndrome ◽  
Miller Fisher Syndrome ◽  
Bilateral Vocal Cord Paralysis ◽  
Fisher Syndrome ◽  
Rare Manifestation ◽  
Guillain Barré

Miller Fisher syndrome (MFS), an acute demyelinating neuropathy, is characterised by a triad of areflexia, ataxia and ophthalmoplegia. It is the most common variant of Guillain-Barre Syndrome (GBS). In about 5.6%–7.1% of MFS cases, patients also suffer from progressive motor weakness of the limbs. This condition is termed MFS/GBS overlap syndrome. Whether it is in MFS or GBS, bilateral vocal cord paralysis (BVCP) is a rare manifestation with limited cases reported in the literature. We report an extremely rare case where a 65-year-old man developed BVCP in an MFS/GBS overlap syndrome. We have also reviewed previous case reports in the literature for comparison.

scholarly journals Unilateral Vocal Cord Paralysis following Insertion of a Supreme Laryngeal Mask in a Patient withSjögren’sSyndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
T. O. J. Masarwa ◽  
I. H. F. Herold ◽  
M. Tabor ◽  
R. A. Bouwman
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Vocal Cord ◽  
Endotracheal Intubation ◽  
Vocal Cord Paralysis ◽  
Case Reports ◽  
Ease Of Use ◽  
Laryngeal Mask ◽  
Less Invasive ◽  
Unilateral Vocal Cord Paralysis

Since its introduction in 1988 by Dr. Archie Brain, the laryngeal mask airway (LMA) is being used with increasing frequency. Its ease of use has made it a very popular device in airway management and compared to endotracheal intubation it is less invasive. The use of LMA was on the rise, so has been the incidence of its related complications. We report severe unilateral vocal cord paralysis following the use of the supreme laryngeal mask (sLMA) in a patient withSjögren’ssyndrome. In addition, we propose possible mechanisms of injury, review the existing case reports, and discuss our findings.

A Sudden Onset of High-Pitched Voice Associated with Unilateral Vocal Cord Paralysis: A Case Report

1974 ◽  
Vol 39 (3) ◽  
pp. 373-375 ◽  
Author(s):  
Ehud Yairi
Keyword(s):  
Case Report ◽  
Vocal Cord ◽  
Case History ◽  
Vocal Cord Paralysis ◽  
Sudden Onset ◽  
Therapeutic Procedures ◽  
History Of ◽  
Unilateral Vocal Cord Paralysis

A case history of a patient with an acquired high-pitched voice is presented, emphasizing unusual history and symptoms. Successful remediation was accomplished through traditional therapeutic procedures.

scholarly journals Non-functioning parathyroid adenoma: a rare differential diagnosis for vocal-cord paralysis

2016 ◽  
Vol 98 (6) ◽  
pp. e94-e96 ◽  
Author(s):  
D Kamali ◽  
A Sharpe ◽  
S Nagarajan ◽  
W Elsaify
Keyword(s):  
Differential Diagnosis ◽  
Parathyroid Adenoma ◽  
Vocal Cord ◽  
Parathyroid Gland ◽  
Vocal Cord Paralysis ◽  
Vocal Cord Palsy ◽  
Rare Differential Diagnosis ◽  
History Of ◽  
Skeletal Bone ◽  
First Time

Introduction Adenomas of the parathyroid gland typically present with symptoms of hyperparathyroidism, manifested by fatigue, bone pain, abdominal pain, weakness, dyspepsia, nephrolithiasis and skeletal bone disease. Here, we describe, for the first time, a case of a non-functioning benign tumour of the parathyroid gland presenting as vocal-cord paralysis. Case History A 49-year-old male presented with a 10-week history of dysphonia and the feeling of having ‘something stuck in my throat’. History-taking elicited no other associated symptoms. Flexible nasal endoscopy demonstrated paralysis of the left vocal cord. Computed tomography of the neck revealed a cystic lesion, 18mm in diameter adjacent to the oesophagus. After more rigorous tests, a neck exploration, left hemithyroidectomy, excision of the left paratracheal mass and level-VI neck dissection was undertaken, without incident to the patient or surgical team. Histology was consistent with a parathyroid adenoma. Conclusions This case emphasises the importance of including adenomatous disease of the parathyroid gland in the differential diagnosis despite normal parathyroid status as a cause of vocal cord palsy.

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