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.

Neonatal Vocal Cord Paralysis Following Extracorporeal Membrane Oxygenation

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 793-796 ◽  
Author(s):  
Robert E. Schumacher ◽  
Irvin J. Weinfeld ◽  
Robert H. Bartlett
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Membrane Oxygenation ◽  
The Right ◽  
Unilateral Vocal Cord Paralysis

Five cases of unilateral vocal cord paralysis/ paresis were diagnosed following extracorporeal membrane oxygenation for newborn respiratory failure. All were right sided and transient in nature. None of the five patients had other findings commonly associated with vocal cord palsy. The extracorporeal membrane oxygenation procedure requires surgical dissection in the carotid sheath on the right side of the neck, an area immediately adjacent to both the vagus and recurrent laryngeal nerve. It is speculated that vocal cord paralysis in these infants was acquired as a result of the extracorporeal membrane oxygenation cannulation. Although the vocal cord paralysis resolved in all cases, two patients had difficult courses after extracorporeal membrane oxygenation. Therefore, laryngoscopic examination should be considered for patients after extracorporeal membrane oxygenation.

scholarly journals Prospective analysis of type I thyroplasty using gore-tex implant

2017 ◽  
Vol 3 (2) ◽  
pp. 276
Author(s):  
Sanjeev Mohanty ◽  
Sreenivas . ◽  
Vinay Raj T. ◽  
Devipriya . ◽  
Vinoth M.
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Vocal Cord Palsy ◽  
Post Treatment ◽  
Type I ◽  
Self Assessment ◽  
Maximum Phonation Time ◽  
Number Of Factors ◽  
Treatment Objective ◽  
Unilateral Vocal Cord Paralysis

<p class="abstract"><strong>Background:</strong> Vocal cord paralysis is a clinical sign caused by paralysis of intrinsic muscles of larynx due to dysfunction of recurrent laryngeal nerve. There are several methods available surgically for the medialisation of the abducted vocal cord. One of the common effective modality is the Gore-Tex medialisation thyroplasty. The results depend on a number of factors including the surgical expertise and extrusion of the Gore –Tex implant. This study is aimed at analysis of all Gore-Tex medialisation thyroplasty done at our centre. Prospectively asses and analyze the vocal outcomes and quality of life of patients in type 1 medialisation thyroplasty using Gore-Tex implant.</p><p class="abstract"><strong>Methods:</strong> Prospective study of 48 months on 30 patients with unilateral vocal cord paralysis.  Surgical procedure for the patients was standardized by using Gore-Tex implant to medialize the cord. Video-Laryngoscopy at end of 1<sup>st</sup> month and stroboscopy &amp; voice analysis at end of 3<sup>rd</sup> month post treatment, the parameters used for the pre and post treatment objective analysis are a) stroboscopic analysis, b) psychoacoustic evaluation, c) maximum phonation time, d) patient’s self-assessment.  </p><p class="abstract"><strong>Results:</strong> In our study of 30 patients with a follow up period of 48 months, we can conclude as follows – a)unilateral vocal cord paralysis does not have age or gender specificity, b)statistically significant vocal cord palsy affects the left side more by 70%, c)post op Gore-tex medialisation thyroplasty showed a statistically highly significant improvement in psychoacoustic, mean phonation time, d)post op Gore-Tex medialisation thyroplasty showed a statistically significant improvement in videostroboscopic analysis.</p><p><strong>Conclusions:</strong> Psycho acoustic, mean phonation time analysis would complement each other in the assessment of the medialisation thyroplasty thus obviating videostroboscopy.</p>

Stridor: a rare presentation of motor neuron disease

2021 ◽  
Vol 14 (7) ◽  
pp. e241923
Author(s):  
Brian Gordon ◽  
Eimear Joyce ◽  
Timothy J Counihan
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Vocal Cord ◽  
Poor Response ◽  
Vocal Cord Palsy ◽  
Pharmacological Therapy ◽  
Rare Presentation ◽  
Emergency Tracheostomy ◽  
Life Threatening ◽  
History Of

A 74-year-old farmer presented to the emergency department with a subacute history of progressive dyspnoea, wheeze and dysphonia. He was treated for an exacerbation of asthma with poor response to pharmacological therapy. Investigation of dysphonia via laryngoscopy identified a bilateral vocal cord palsy. Subsequently, the patient developed an episode of life-threatening stridor and hypercapnic respiratory failure requiring an emergency tracheostomy. Neurology input identified evidence of widespread muscle fasciculations on clinical examination. MRI of the brain and cervical spine were unremarkable. Electromyogram testing identified changes of acute denervation in several limbs consistent with a diagnosis of motor neuron disease (MND). Bilateral vocal cord palsy has been rarely reported in the literature as the heralding symptom resulting in the diagnosis of MND. In patients with a subacute onset of dysphonia, dyspnoea and stridor, MND should be a differential diagnosis.

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.

Paraganglioma: an unusual tumour of the parathyroid gland

1996 ◽  
Vol 110 (2) ◽  
pp. 196-199 ◽  
Author(s):  
W. G. McCluggage ◽  
C. H. S. Cameron ◽  
D. Brooker ◽  
M. D. O'Hara
Keyword(s):  
Electron Microscopy ◽  
Differential Diagnosis ◽  
Parathyroid Adenoma ◽  
Parathyroid Gland ◽  
Incidental Finding ◽  
Squamous Carcinoma ◽  
Pathological Features ◽  
Unusual Variant ◽  
The Right ◽  
Inferior Parathyroid Gland

AbstractA case of paraganglioma arising within a parathyroid gland is reported. The lesion was an incidental finding in a block dissection of neck performed for squamous carcinoma of the pharynx. A well-circumscribed lesion, exhibiting the characteristic pathological features of a paraganglioma, was embedded within the right inferior parathyroid gland. Due to its location, the chief histological differential diagnosis was an unusual variant of parathyroid adenoma. Immunohistochemistry and electron microscopy assisted in reaching a diagnosis. This, as far as we are aware, is the first reported case of a paraganglioma of the parathyroid gland.

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.

scholarly journals Correlation of electroglottograph with vocal cord pathology

2016 ◽  
Vol 3 (1) ◽  
pp. 46 ◽  
Author(s):  
Shilpa Chandrashekarappa ◽  
Sandeep S. ◽  
Sandeep Jain ◽  
Guruswamy M. ◽  
Shivaram T. Shetty
Keyword(s):  
Vocal Cord ◽  
Clinical Examination ◽  
Cost Effective ◽  
Vocal Cord Palsy ◽  
Mass Lesion ◽  
Closing Time ◽  
Vocal Cords ◽  
Significant Difference ◽  
Invasive Method ◽  
History Of

<p class="abstract"><strong>Background:</strong> Vocal cord disorders are very commonly encountered in ENT Outpatient. Electroglottogram is a non-invasive method for the examination of the vocal fold vibrations.  It exerts no influence at all on articulation and production of sound and is cost effective. The aim of the present study was to validate the clinical correlation of electroglottogram in patients presenting with hoarseness of voice<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 30 patients with history of hoarseness of voice and 30 normals were selected from ENT outpatient and inpatient department over a period of 2 years. All subjects underwent detailed ENT history taking, clinical examination, rigid laryngoscopy and electroglottography and results were documented<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Electroglottography waveforms of various voice disorders like vocal cord nodule, polyp, papilloma and haemangioma showed specific changes like double peak or notch in closing phase of waveform in case of mass lesion over the vocal cords and fuzzy waveform with prolonged closing time in case of vocal cord palsy. Significant difference was noted in certain electroglottographic parameters for phonated vowels /a/, /i/ and /u/ for certain vocal cord disorders<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Electroglottograph helps in diagnosing the pathology related to vocal cords, whether it is mass lesion over the vocal cords or vocal cord palsy but to differentiate in between mass lesions, clinical examination has to be done to confirm the diagnosis<span lang="EN-IN">.</span></p>

scholarly journals Schwannoma of upper eyelid: A rare differential diagnosis of eyelid swellings

2010 ◽  
Vol 43 (02) ◽  
pp. 213-215
Author(s):  
Surendra B. Patil ◽  
Satish M. Kale ◽  
Sumeet Jaiswal ◽  
Nishant Khare
Keyword(s):  
Differential Diagnosis ◽  
Lower Eyelid ◽  
Lateral Part ◽  
Upper Eyelid ◽  
Eyelid Skin ◽  
Rare Differential Diagnosis ◽  
History Of ◽  
Upper Lid ◽  
Painless Mass ◽  
Rare Benign Tumour

ABSTRACTSchwannoma is a relatively rare benign tumour of peripheral nerve origin. The occurrence of Schwannoma in eyelid is extremely rare. As per our knowledge, only 11 such cases have been reported in the literature so far. We present a case of a 40-year-old man who presented to us with a 2-year history of slowly enlarging, painless mass in his left upper lid with resultant progressive ptosis. Ocular examination was suggestive of a firm, non-tender nodule of size 2 × 1.5 × 1 cm on the left upper lid. The mass was non-adherent to the skin or the underlying tissue. The eyelid skin and conjunctiva were indurated and signs of inflammation were present. The lateral part of eyelid showed presence of an ulcer and the lid function was severely hampered. Provisional clinical diagnosis was that of an eyelid malignancy. With this in mind, the medial part of the lid was excised and reconstructed using a tarso-conjunctival flap from the lower eyelid in conjunction with a skin graft. The histopathology and immunohistochemistry established the diagnosis of Schwannoma. We recommend that Schwannoma be considered in the differential diagnosis of well-circumscribed eyelid swellings.

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