Vocal cord palsy and getting to know it better

Background: Vocal cord palsy is a challenging entity encountered by otolaryngologists in clinical practice. It is a sign of an underlying pathology. Vocal cord palsy requires thorough examination and needs to be investigated. We conducted a study to identify the various etiology of vocal cord palsy and the various modalities of treatment. Methods: A prospective study was conducted to study the various etiologies and modalities of treatment of vocal cord palsy. A total of 55 patients with vocal cord palsy were included in our study based on the inclusion and exclusion criteria. Patients diagnosed with vocal cord paralysis were followed up and the various modalities of treatment were studied. Results: Males outnumbered females. Among patients of unilateral vocal cord paralysis left vocal cord was paralyzed in majority of the cases (30 patients). Vocal cord paralysis has a variable etiology. Neoplastic causes accounted for the largest number of patients followed by iatrogenic causes. The modality of treatment depends on the etiology. Patients with unilateral vocal cord palsy speech therapy were our modality of treatment. No surgical intervention was done for unilateral vocal cord palsy. Five patients with bilateral vocal cord palsy underwent Kashima’s operation. Conclusions: Vocal cord palsy is a symptom of an underlying disorder and not a disease. In our study malignancy is the commonest etiology for vocal cord palsy.

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Neonatal Vocal Cord Paralysis Following Extracorporeal Membrane Oxygenation

PEDIATRICS ◽

10.1542/peds.84.5.793 ◽

1989 ◽

Vol 84 (5) ◽

pp. 793-796 ◽

Cited By ~ 1

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.

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Prospective analysis of type I thyroplasty using gore-tex implant

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171177 ◽

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

Background: 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.Methods: 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 1st month and stroboscopy & voice analysis at end of 3rd 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. Results: 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.Conclusions: Psycho acoustic, mean phonation time analysis would complement each other in the assessment of the medialisation thyroplasty thus obviating videostroboscopy.

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Clinico-etiological Profile of Vocal Cord Paralysis

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2019.v27i3.13 ◽

2019 ◽

Vol 27 (3) ◽

pp. 229-234

Author(s):

Shivakumar Senniappan ◽

Govind Krishnan Gopalakrishnan ◽

Chinnu Sudha Kumar ◽

Anjali Mahendra Panicker ◽

Visakh Kookkal Nair ◽

...

Keyword(s):

Vocal Cord ◽

Vocal Fold ◽

Vocal Cord Paralysis ◽

Vocal Cord Palsy ◽

Vocal Fold Paralysis ◽

Cross Sectional ◽

One Year ◽

Underlying Pathology ◽

Peripheral Origin ◽

Rule Out

Introduction Vocal Cord Paralysis may be of central or peripheral origin based on the underlying pathology. Central Causes contribute about 10% while peripheral causes about 90% and the current study evaluated the clinical profile of vocal cord paralysis. Materials and Methods A cross-sectional observational study was conducted in the department of ENT for a period of one year. Patients with complaints of hoarseness or aspiration who on laryngoscopy examination with 45° telescope have been diagnosed to have vocal cord paralysis were included for the study. A total of 83 patients were included in our study. Results Vocal cord palsy was found most commonly after thyroidectomy (20.4%) followed by the idiopathic cause (19.2%). Certain cancers like lung cancer and neck cancers (hypopharyngeal, laryngeal and thyroid) carcinoma had also contributed significantly in the development of vocal cord palsy. Left sided vocal cord palsy (65%) was found to be the commonest side affected followed by bilateral vocal cord palsy. Conclusion A proper protocol is necessary for identifying the factors responsible for vocal fold paralysis which would help in managing the condition more effectively. Before making a diagnosis as idiopathic vocal cord paralysis, detailed investigations should be carried out to rule out the possibilities of cancer, causing vocal cord paralysis.

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