Inspiratory and Expiratory Vocal Cord Dysfunction: An Upper Airway Obstruction With a Unique Morphological and Quantitative Diagnostic Criteria

Introduction: Vocal cord paralysis often causes mortality by upper airway obstruction in some neurodegenerative diseases such as Parkinson’s disease and multiple system atrophy. Vocal cord paralysis is uncommon in Parkinson’s disease (PD) in contrary it is more common in multiple system atrophy (MSA). The pathogenesis of vocal cord paralysis in Parkinson’s disease is not well understood but may involve degeneration of the nucleus ambiguous. In terms of managing patient with bilateral vocal cord paralysis in PD, it can be either performing tracheostomy to relive the upper airway obstruction or by optimizing the medical treatment. There are very few available reported cases whereby patient are treated with medical treatment alone.Case Report: We report a case of 65 years old lady who presented with stridor resulting from bilateral vocal cord paralysis and she has been diagnosed to have Parkinson’s disease for more than 10 years. She had her antiparkinson medication optimized and requiring no surgical intervention to relieve the upper airway obstruction.Conclusion: In conclusion we would like to emphasize that it is important to recognize bilateral vocal cord paralysis in Parkinson’s disease and early optimization of medical treatment could avoid a need of tracheostomy.

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Upper airway obstruction with bilateral vocal cord paralysis secondary to ischemic stroke: Reports of two cases

Rinsho Shinkeigaku ◽

10.5692/clinicalneurol.48.333 ◽

2008 ◽

Vol 48 (5) ◽

pp. 333-337

Author(s):

Yasuyuki Ito ◽

Akira Mori ◽

Kiminobu Yonemura ◽

Yoichiro Hashimoto ◽

Teruyuki Hirano ◽

...

Keyword(s):

Ischemic Stroke ◽

Airway Obstruction ◽

Vocal Cord ◽

Vocal Cord Paralysis ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Bilateral Vocal Cord Paralysis

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Acute upper airway obstruction following Teflon injection of a vocal cord; the value of nebulized adrenaline and a helium/oxygen mixture in its management

The Journal of Laryngology & Otology ◽

10.1017/s0022215100113519 ◽

1990 ◽

Vol 104 (8) ◽

pp. 654-655 ◽

Cited By ~ 11

Author(s):

Neil B. Solomons ◽

Jonathan R. Livesey

Keyword(s):

Airway Obstruction ◽

Vocal Cord ◽

Upper Airway ◽

Vocal Cord Palsy ◽

Upper Airway Obstruction ◽

Oxygen Mixture ◽

Post Operative Period ◽

History Of ◽

The Right

AbstractA 67-year-old man presented with a 45-year history of a weak voice. This was the result of polio which had left him with a right vocal cord palsy.The patient underwent a Teflon injection of the right vocal cord under general anaesthesia to improve the quality of his voice. In the immediate post-operative period, he suffered acute upper airway obstruction. The problem of acute upper airway obstruction following Teflon injection is considered and its management with nebulized adrenaline and a helium/oxygen mixture is discussed.

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Carbon Dioxide Laser Posterior Cordectomy for Treatment of Bilateral Vocal Cord Paralysis

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948909801203 ◽

1989 ◽

Vol 98 (12) ◽

pp. 930-934 ◽

Cited By ~ 153

Author(s):

Donald P. Dennis ◽

Haskins Kashima

Keyword(s):

Carbon Dioxide ◽

Airway Obstruction ◽

Vocal Cord ◽

Carbon Dioxide Laser ◽

Vocal Cord Paralysis ◽

Voice Quality ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Bilateral Vocal Cord Paralysis ◽

Initial Improvement

Upper airway obstruction due to bilateral vocal cord paralysis was successfully relieved by carbon dioxide laser posterior cordectomy. All patients achieved satisfactory airway and decannulation. Flow-volume loop spirograms obtained preoperatively and postoperatively documented improved flow rates on inspiration and expiration. Final voice quality was subjectively good in all patients. Follow-up has ranged from 1 year 10 months to 5 years 8 months, and initial improvement has been sustained in all cases. Carbon dioxide laser posterior partial cordectomy is an alternative management option for relief of upper airway obstruction due to bilateral vocal cord paralysis. The procedure can be performed without prophylactic tracheotomy. Subjectively good voice quality is preserved.

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DOCUMENTATION OF UPPER AIRWAY OBSTRUCTION IN UNILATERAL VOCAL CORD PARALYSIS

The Laryngoscope ◽

10.1288/00005537-198407000-00013 ◽

1984 ◽

Vol 94 (7) ◽

pp. 923???937 ◽

Cited By ~ 33

Author(s):

HASKINS K. KASHIMA

Keyword(s):

Airway Obstruction ◽

Vocal Cord ◽

Vocal Cord Paralysis ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Unilateral Vocal Cord Paralysis

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Recurrent stridor in an infant

BMJ Case Reports ◽

10.1136/bcr-2021-244012 ◽

2021 ◽

Vol 14 (9) ◽

pp. e244012

Author(s):

Chien Ying Vincent Ngu ◽

Jeyasakthy Saniasiaya ◽

Jeyanthi Kulasegarah

Keyword(s):

Airway Obstruction ◽

Vocal Cord ◽

Detrimental Effect ◽

Upper Airway ◽

Vocal Cord Palsy ◽

Upper Airway Obstruction ◽

Inspiratory Stridor ◽

Paediatric Age ◽

Chiari Ii

Paediatric upper airway obstruction is an emergency that requires immediate intervention. Among the myriad factors that leads to upper airway obstruction in paediatric age group, bilateral vocal cord palsy is not commonly encountered in clinical practice. The underlying cause of bilateral vocal cord palsy requires thorough investigation prior to deciding on the appropriate intervention. Herein, we report a 4-month-old baby boy who presented with recurrent inspiratory stridor with bilateral vocal cord palsy secondary to Arnold Chiari II malformation. Immediate intervention to drain the hydrocephalous resulted in complete resolution of stridor without having to perform a tracheostomy. We highlight the importance of meticulous and thorough investigations especially in children, as emergent airway intervention such as tracheostomy may result in detrimental effect to speech, swallowing as well as quality of life.

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