scholarly journals Diagnostic difficulties in children with iatrogenic vocal cord paralysis in the material of the Department of Pediatric Otolaryngology of the Medical University of Warsaw

New Medicine ◽  
2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Monika Jabłońska-Jesionowska ◽  
Lidia Zawadzka-Głos
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Signs And Symptoms ◽  
Diagnostic Methods ◽  
Prolonged Intubation ◽  
Pediatric Otolaryngology ◽  
Diagnostic Difficulties ◽  
Integrated Interpretation ◽  
Medical University ◽  
Unilateral Vocal Cord Paralysis

Introduction. The causes of vocal cord paralysis in children include congenital malformations, nervous system disorders, and iatrogenic causes. The paralysis may affect one or both cords. The signs of bilateral vocal cord paralysis include respiratory stridor of varying severity, and even acute respiratory failure. The signs and symptoms of unilateral vocal cord paralysis include phonation and swallowing disorders, as well as respiratory stridor associated with partial stenosis of already physiologically narrow airways in children. Diagnosing the cause for vocal cord paralysis in children is difficult. Aim. The aim of the study was to analyze the causes of iatrogenic vocal cord paralysis, as well as to assess the usefulness of diagnostic methods used in children with iatrogenic vocal chords paralysis. Material and methods. A retrospective analysis of clinical data of 20 children with iatrogenic vocal cord paralysis under the care of the Department of Pediatric Otolaryngology of the Medical University of Warsaw in 2017 was conducted. Results. The study group included 13 boys and 7 girls aged from 1 month of age to 10 years of age; median age at the diagnosis was 3 months. In 17 children, bilateral paralysis was diagnosed, and 3 children were diagnosed with unilateral paralysis. The cause of iatrogenic vocal cord paralysis in 7 children was cardiac surgery, in 1 ? thoracic surgery, in 7 ? prolonged intubation, in 3 ? perinatal hypoxia, and in 2 ? vincristine chemotherapy. Conclusions. The diagnosis of iatrogenic vocal cord paralysis is difficult. The applied diagnostic methods require an integrated interpretation. The larynx ultrasound (US) examination remains very useful in the assessment of the vocal cords mobility in children, however, it is not possible to perform this examination in intubated patients. Fiberoscopy, performed under local anesthesia, is widely available, however, performing it on a narrow larynx of a child may cause respiratory disorders. US and fiberoscopy in infants should be supplemented by direct laryngoscopy in order to exclude congenital airway defects that may have symptoms similar to them. In any case, neurological disorders and genetic defects causing vocal cord paralysis must be excluded.

Unilateral vocal cord paralysis following endotracheal intubation

1998 ◽  
Vol 42 (1) ◽  
pp. 131-132 ◽  
Author(s):  
R. J. LaursenM.D ◽  
K. M. Larsen ◽  
J. Mølgaard ◽  
V. Kolze
Keyword(s):  
Vocal Cord ◽  
Endotracheal Intubation ◽  
Vocal Cord Paralysis ◽  
Unilateral Vocal Cord Paralysis

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>

scholarly journals Thyroplasty type I for Unilateral Vocal Cord Paralysis

1991 ◽  
Vol 2 (2) ◽  
pp. 259-265
Author(s):  
Jae Shik Cho ◽  
Chong Won Lee ◽  
In Won Chang ◽  
Seung Min Ryu ◽  
Seon Tae Kim
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Type I ◽  
Unilateral Vocal Cord Paralysis

Idiopathic posterior laryngeal web on an adult patient

2021 ◽  
Vol 14 (5) ◽  
pp. e242561
Author(s):  
Georgios Chrysovitsiotis ◽  
Spyridon Potamianos ◽  
Spyros Katsinis ◽  
Efthymios Kyrodimos
Keyword(s):  
Adult Patient ◽  
Vocal Cord ◽  
Revision Surgery ◽  
Initial Treatment ◽  
Vocal Cord Paralysis ◽  
Adult Life ◽  
Patient Treatment ◽  
Prolonged Intubation ◽  
Careful Investigation

Posterior laryngeal webs are uncommon pathologies that are usually acquired at some point in adult life. Prior and prolonged intubation is the leading cause for developing such lesions. In certain rare cases of posterior laryngeal webs, no identifiable cause can be associated with the development of this pathology. We present a case with such an idiopathic lesion. Surgery is the treatment of choice. Several techniques and modifications can be used, to achieve maximum airway release and, at the same time, ensure that restenosis will be avoided. Our patient recurred following initial treatment and a more complex revision surgery was necessary. Special attention should be given in differentiating these lesions from abductor vocal cord paralysis. Furthermore, careful investigation of the cause and individualisation of patient treatment are crucial.

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