scholarly journals Strumos chirurginio gydymo pavojai: pooperacinis balso klosčių paralyžius

2006 ◽  
Vol 4 (2) ◽  
pp. 0-0
Author(s):  
Algimantas Žindžius ◽  
Virgilijus KKrasauskas ◽  
Jelena Jončiauskienė
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Vocal Cord Palsy ◽  
Early Postoperative Period ◽  
Laryngeal Nerve ◽  
Vocal Cords

Algimantas Žindžius, Virgilijus kKrasauskas, Jelena JončiauskienėKauno medicinos universiteto Chirurgijos klinikaEivenių g. 2, LT-50009 Kaunas Tikslas Retrospektyviuoju tyrimu, remiantis medicininės dokumentacijos duomenų analize, įvertinti toksinės ir netoksinės strumos chirurginio gydymo pavojus, pooperacinio balso klosčių paralyžiaus rizikos veiksnius, nustatyti ir palyginti šios komplikacijos dažnumą, atsižvelgiant į operacijos indikacijas, apimtį ir metodiką. Ligoniai ir metodai Išnagrinėtos ligos istorijos 5555 pacientų, operuotų Kauno medicinos universiteto klinikų Chirurgijos klinikoje 1998–2004 metais. Skydliaukės operacijos atliktos subfascine ir atvirąja metodika, neidentifikuojant arba identifikuojant grįžtamuosius gerklų nervus. Rezultatai Pooperacinis balso klosčių paralyžius ištiko 127 (2,29%) pacientus: vienos balso klostės klostės – 104 (1,87%), abipusis – 23 (0,41%) pacientus. Po 350 operacijų nuo strumos recidyvo balso klosčių paralyžius pasireiškė 25 (7,14%) pacientams: 16 (4,57%) – vienpusis, 9 (2,57%) – abipusis. Nustatyta, kad chirurginis gydymas pritaikytas įvairioms strumos klinikinėms formoms, skyrėsi tik laikotarpiu, kai į gydymą įsitraukė chirurgai. Išvados Dažniausia skydliaukės operacija yra tiroidektomija (42,11%), dažniausia komplikacija – pooperacinis balso klosčių paralyžius (2,29%). Grįžtamojo gerklų nervo sužalojimus lemia įvairūs veiksniai – strumos patologinė morfologija, ligos recidyvas, ilgalaikis medikamentinis gydymas, nepalankūs skydliaukės ir gretimų struktūrų anatomijos variantai, operacijos apimtis, operacijos metodas. Dėl abipusio balso klosčių paralyžiaus ankstyvuoju pooperaciniu laikotarpiu 4 pacientams kilus kvėpavimo nepakankamumui, tracheostomijos buvo išvengta atlikus vienos balso klostės šoninę fiksaciją. . Reikšminiai žodžiai: struma, chirurginis gydymas, grįžtamojo gerklų nervo pažeidimas, balso klosčių paralyžius Dangers of thyroid surgery: postoperative paralysis of vocal cords Algimantas Žindžius, Virgilijus kKrasauskas, Jelena JončiauskienėKaunas University of Medicine, Surgery Clinic,Eivenių g. 2, LT-50009 Kaunas, Lithuania  Objective The aim of this article is to evaluate retrospectively dangers of the surgical treatment of toxic and nontoxic goiter. We also analyzed the risk factors of postoperative vocal cord paralysis, evaluated and compared the frequency of this complication depending on the indications, extent and methods of surgery. Patients and methods Three thousand eight hundred ninety seven operations on the thyroid were performed at the Clinic of Surgery of Kaunas University of Medicine Hospital during the period 1998–2002. The operations on the thyroid gland have been performed by subfascial and open methods, identifying the recurrent laryngeal nerves. Results Postoperative vocal cord paralysis developed in 97 (2.49%) cases. One-sided vocal cord palsy developed in 81 (2.08%) patients and bilateral in 16 (0.41%) patients. There were 19 (7.49%) cases of vocal cord palsy after 256 operations performed due to recurrent goiter, 13 being one-sided and 6 bilateral. It has been found that surgical treatment is suitable for all clinical forms of goiter, the only difference being the time the surgeons enter the process of treatment. Conclusions The most frequent thyroid gland operation is thyroidectomy (35.69%) and the most frequent complication is postoperative vocal cord paralysis (2.49%). The injuries to the recurrent laryngeal nerve are determined by both objective (thyroid gland pathology, thyroid cancer, recurrence of goiter, long-lasting medical treatment, unfavorable variants of thyroid gland and adjacent anatomic structures and the extent of operation) and subjective factors (methods of operation, surgeon’s experience, operative technique). Individual selection of open or subfascial methods of thyroid operation gives hope to reduce the complications of the surgical treatment. The respiratory insufficiency developing in the early postoperative period due to bilateral vocal cord paralysis can be cured by performing vocal cord laterofixation instead of tracheostomy. Key words: goiter, surgical treatment, recurrent laryngeal nerve palsy, paralysis of vocal cords

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.

Dysphonia

2018 ◽  
Author(s):  
Aziz Shaibani
Keyword(s):  
Myasthenia Gravis ◽  
Parkinson Disease ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Neuromuscular Disorders ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Vocal Cords

Lack of function or malfunction of the vocal cords are not as common manifestations of neuromuscular disorders as dysarthria. It is typically seen in central diseases such as Parkinson disease. Certain muscle and nerve disorders affect the vocal cords, but in these cases, other features of these diseases make the diagnosis easy. Myasthenia gravis (MG) may present with intermittent hoarseness only early in the course of the disease. Consultation with an ear, nose, throat (ENT) specialist is recommended to characterize the type of cord pathology. Hysterical hoarseness and weakness are not unusual presentations to neuromuscular clinics. Unilateral vocal cord palsy is usually due to recurrent laryngeal nerve pathology.

scholarly journals Recurrent laryngeal nerve palsy due to displacement of a gastric band

2016 ◽  
Vol 98 (8) ◽  
pp. e152-e153 ◽  
Author(s):  
JM Fussey ◽  
F Ahsan
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Gastric Band ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Increased Risk ◽  
Left Recurrent Laryngeal Nerve ◽  
Long Course ◽  
Oesophageal Pathology

The left recurrent laryngeal nerve is at increased risk of compression by oesophageal pathology due to its long course through the neck and thorax. Here we report a case of left vocal cord palsy secondary to displacement of a gastric band, resulting in oesophageal dilatation and neuropraxia of the left recurrent laryngeal nerve. Vocal cord function partially improved following removal of the gastric band.

PS01.189: A STUDY ON THE UTILITY OF INTRAOPERATIVE NEUROSTIMULATION MONITORING SYSTEM FOR RECURRENT LARYNGEAL NERVE IN ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 103-103
Author(s):  
Fumiaki Kawano ◽  
Shinsuke Takeno ◽  
Kousei Tashiro ◽  
Rouko Hamada ◽  
Yasuyuki Miyazaki ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Postoperative Management ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Recurrent Nerve ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Stimulation Of

Abstract Background Recurrent laryngeal nerve paralysis in esophagectomy is one of the most concerned complications. In recent years, intraoperative neurostimulation monitoring system (IONM) in thyroid surgery have been widespread for identification of recurrent laryngeal nerve and assessment of soundness. Therefore, IONM is often used during esophagectomy in Japan. In this study, we examined the efficacy of IONM in the patients undergoing esophagectomy. Methods Of 66 patients underwent esophagectomy since April 2015 until December 2017, IONM used in 27 patients in the surgery for the examination of recurrent nerve paralysis. We retrospectively reviewed these cases for intraoperative findings, neurostimulation monitoring findings and their outcomes. Results Of 27 patients, 25 were male and two were female, and the median age at operation was 66 years old. Although IONM was used in cervical lymph node dissection, there were no vocal cord responses in 5 patients (left side in 4 and right side in 1) with stimulation of the vagus nerve. Because all patients had no vocal cord paralysis due to stimulation of the cervical recurrent laryngeal nerve, it was diagnosed that there was the recurrent laryngeal nerve injury due to thoracic para recurrent nerve lymph node dissection. IONM was able to facilitate the identification and preservation of cervical recurrent nerve in all patients. Three out of 5 patients with no vocal cord response by IONM were confirmed recurrent laryngeal nerve paralysis in postoperative endoscope. In patients with vocal cord paralysis by IONM, it was possible to carefully performed postoperative management. On the other hand, in patients without paralysis, extubation on the operation day seemed possible without the concern for aspiration. Conclusion By using IONM in esophagectomy, we were able to evaluate the damage of the recurrent laryngeal nerve in real-time. Confirming the intraoperative recurrent nerve injuries is important for postoperative management or prediction of postoperative aspiration pneumonia. IONM in esophagectomy was useful not only in terms of surgical procedures but also in the evaluation of postoperative management. Disclosure All authors have declared no conflicts of interest.

Vocal Cord Paralysis Associated with Cystic Fibrosis

1987 ◽  
Vol 96 (6) ◽  
pp. 680-683 ◽  
Author(s):  
Robert P. Zitsch ◽  
James S. Reilly
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Artery ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Recurrent Laryngeal Nerve Injury ◽  
Pulmonary Artery Hypertension ◽  
Laryngeal Nerve ◽  
Close Proximity ◽  
Great Vessels

The course of the left recurrent laryngeal nerve through the chest brings it in close proximity with the heart and great cardiac vessels. Diseases of the heart and the great vessels are known to cause vocal cord paralysis, probably by mechanical injury to the recurrent laryngeal nerve. Pulmonary artery hypertension and dilation occur in up to 80% of patients with cystic fibrosis. We report a case of a 23-year-old woman with cystic fibrosis and left vocal cord paralysis. We believe that sudden pulmonary artery expansion produced recurrent laryngeal nerve injury and vocal cord paralysis. This is only the second association of unilateral vocal cord paralysis and cystic fibrosis in the medical literature. The pathophysiology of the cardiovocal syndrome is discussed.

Recurrent laryngeal nerve palsy following heart-lung transplantation: three cases of vocal cord augmentation in the acute phase

1989 ◽  
Vol 103 (10) ◽  
pp. 968-969 ◽  
Author(s):  
G. E. Murty ◽  
M. C. F. Smith
Keyword(s):  
Lung Transplantation ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Acute Phase ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Bronchial Tree ◽  
Laryngeal Nerve ◽  
Vocal Cord Dysfunction ◽  
Laryngeal Nerve Palsy

AbstractThree cases of left recurrent laryngeal nerve palsy following heart-lung transplantation are described. In each case, within twelve hours of extubation, the left vocal cord was injected with Teflon, and the paralyzed vocal cord thus displaced to the midline. Effective closure of the glottis was then possible, permitting an adequate cough, adequate clearing of the bronchial tree and minimising the risk of aspiration. Augmentation under general anaesthesia as soon as possible after discovery of vocal cord dysfunction is advocated. Suitable materials for injection are discussed. To our knowledge, this is the first reported series of vocal cord augmentation in the acute phase following heart-lung transplantation.

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