scholarly journals Fish Bone Migration- Culprit Leading to RetroParaoesophageal Abscess, Mediastinitis and Vocal Cord Palsy

2020 ◽  
Vol 18 (3) ◽  
Author(s):  
Paul M ◽  
Shashigopalan M ◽  
Johnson NWS
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Palsy ◽  
Fish Bone ◽  
Neck Exploration ◽  
Oesophageal Perforation ◽  
Anatomical Features ◽  
Vocal Cord Paresis ◽  
Life Threatening

Fish bone ingestion and impaction are known to everyone. However, such benign incidences have been reported to be associated with multiple potentially life threatening complications. Anatomical features of the oesophagus forms the basis for such incidences. We report here an elderly diabetic gentleman with an unusual left retro-paraoesophageal abscess complicated with oesophageal perforation, mediastinitis and vocal cord paresis which were fundamentally caused by a migrated fish bone into the lower part of the neck requiring therapeutic external neck exploration. Management of this case and its complications are described here comprehensively.

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.

scholarly journals Extralaryngeal branching of the recurrent laryngeal nerve. Autopsy case series

2021 ◽  
Vol 14 (4) ◽  
pp. 4-18
Author(s):  
Aleksandr A. Kuprin ◽  
Viktor Y. Malyuga ◽  
Timur A. Britvin ◽  
Ivan O. Abuladze
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Case Series ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Autopsy Case ◽  
Anatomical Features ◽  
Anatomical Variants ◽  
Vocal Cord Paresis ◽  
Extralaryngeal Branching

Background. The thesis «thyroid surgery is the surgery of the recurrent laryngeal nerve», which was defined in the XX ­century, remains relevant to this day. Thus, despite the use of modern scientific and technological achievements, vocal cord paresis is diagnosed on average in 9.8% patients after thyroid and parathyroid surgery.According to many authors, the main problem which a surgeon encounters is a difficult and sometimes individual anatomy of the recurrent laryngeal nerve. For example, in one study authors identified 28 variants of relationships between the ­recurrent laryngeal nerve and the inferior thyroid artery. In a recent meta-analysis, it was noted that the frequency of extralaryngeal branching remains underestimated and reaches 73% of cases. Anatomical variants of the recurrent laryngeal nerve or its thin branches, which have not been noticed in time, can lead to inevitable consequences — to nerve injury and a laryngeal dysfunctions, and if anatomical features are not detected on both sides — to a tragedy.Aim. The aim of this study is to determine anatomical variants of the extralaryngeal branches of the recurrent laryngeal nerve and their frequency in autopsy case series.Materials and methods. 46 (100%) recurrent laryngeal nerves were dissected in 23 cadavers. Their path was traced, their relationships with the inferior thyroid artery were determined, and the extralaryngeal branches of the recurrent laryngeal nerve were identified.Results. Few extralaryngeal branches of the recurrent laryngeal nerve were identified during dissection: tracheoesophageal branches, laryngeal branches, aberrant branches. Tracheoesophageal branches were determined in all cadavers. In 37 (80.4%) cases the recurrent laryngeal nerve had got two or more extralaryngeal laryngeal branches. In 6 (13.0%) cases aberrant branches were presented.The inferior thyroid artery was detected in 42 (91.3%) cases. The vessel was in close location with the recurrent laryngeal nerve, forming a neuro-arterial chiasm. In 39.1% of cases the recurrent laryngeal nerve was located between the branches of the inferior thyroid artery, in 39.1% of cases — deeper than the artery, and in 10.9% of cases — more superficial than the artery.Conclusion. The variable anatomical configuration of the recurrent laryngeal nerve inevitably causes difficulties during intraoperative nerve dissection. Tardy identification of these anatomical features can lead to the injury of nerves or its branches, which determines the amount of postoperative vocal cord paresis.

scholarly journals Computerized Tomographic Assessment of Vocal Cord Palsy: Otolaryngologist's Purview

2016 ◽  
Vol 6 (2) ◽  
pp. 57-63
Author(s):  
Apoorva K Pandey ◽  
Tripti Maithani ◽  
Arvind Varma ◽  
Sharad Gangrade ◽  
Ankur Malhotra
Keyword(s):  
Vocal Cord ◽  
Three Dimensional ◽  
Vocal Cord Palsy ◽  
Pyriform Sinus ◽  
Radiologic Evaluation ◽  
Aryepiglottic Fold ◽  
Key Points ◽  
Dimensional Reconstruction ◽  
Life Threatening ◽  
Axial Ct

ABSTRACT Aims and objectives Vocal cord palsy (VCP) can be definitely depicted on computed tomograpy (CT) scan by identifying key points at the level of true vocal cords and aryepiglottic folds. There are various VCP mimics and imaging shortcomings, and these can usually be circumvented by thoughtfully assessing the scan plan and level, and a diligent search for additional characteristics. Materials and methods This retrospective study consisted of 10 cases of unilateral VCP, who all had been clinically diagnosed of VCP and further evaluated by CT. Pre- and postcontrast enhanced axial CT from skull base to aorto-pulmonary window were done and multiplanar three-dimensional reconstruction of images in coronal and sagittal planes along with volume-rendered imaging was done. Results Most consistent findings in VCP were thickening of ipsilateral aryepiglottic fold and medialization of ipsilateral aryepiglottic fold (100%), followed by dilation of ipsilateral pyriform sinus (90%) and dilatation of ipsilateral laryngeal ventricle (80%). Etiologic causes were ascertained in three cases: Thyroid malignancy, tuberculosis, and pyriform sinus malignancy. The last etiology was probably a VCP mimic. Conclusion Radiologic evaluation is inarguably useful for determining the etiology of VCP, particularly for lesions within neck and thoracic cavity. Most crucial objective in assessing a case of VCP is to exclude the presence of a life-threatening primary lesion as the cause of VCP. How to cite this article Pandey AK, Gangrade S, Malhotra A, Varma A, Maithani T. Computerized Tomographic Assessment of Vocal Cord Palsy: Otolaryngologist's Purview. Int J Phonosurg Laryngol 2016;6(2):57-63.

Central Vocal Cord Paresis as Complication of a FBXL4-Associated Mitochondrial Depletions Syndrome

2016 ◽  
Vol 47 (S 01) ◽  
Author(s):  
C. Decker ◽  
N. Teig ◽  
A. Abicht ◽  
E. Holinski-Feder ◽  
C. Köhler ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paresis

scholarly journals Vocal cord palsy as a sequela of paediatric cardiac surgery – a review

2021 ◽  
pp. 1-9
Author(s):  
Aditi Sinha ◽  
Alexander Geragotellis ◽  
Guntaj Kaur Singh ◽  
Devika Verma ◽  
Daniyal Matin Ansari ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Vocal Cord ◽  
Vocal Fold ◽  
Heart Surgery ◽  
Vocal Cord Palsy ◽  
Standards Of Care ◽  
Management Options ◽  
Paediatric Cardiac Surgery ◽  
Cord Injury ◽  
Pda Ligation

Abstract Background: Vocal cord palsy is one of the recognised complications of complex cardiac surgery in the paediatric population. While there is an abundance of literature highlighting the presence of this complication, there is a scarcity of research focusing on the pathophysiology, presentation, diagnosis, and treatment options available for children affected by vocal cord palsy. Materials and methods: Electronic searches were conducted using the search terms: “Vocal Cord Palsy,” “VCP,” “Vocal Cord Injury,” “Paediatric Heart Surgery,” “Congenital Heart Surgery,” “Pediatric Heart Surgery,” “Vocal Fold Movement Impairment,” “VFMI,” “Vocal Fold Palsy,” “PDA Ligation.” The inclusion criteria were any articles discussing the outcomes of vocal cord palsy following paediatric cardiac surgery. Results: The two main populations affected by vocal cord palsy are children undergoing aortic arch surgery or those undergoing PDA ligation. There is paucity of prospective follow-up studies; it is therefore difficult to reliably assess the current approaches and the long-term implications of management options. Conclusion: Vocal cord palsy can be a devastating complication following cardiac surgery, which if left untreated, could potentially result in debilitation of quality of life and in severe circumstances could even lead to death. Currently, there is not enough high-quality evidence in the literature to aid recognition, diagnosis, and management leaving clinicians to extrapolate evidence from adult studies to make clinical judgements. Future research with a focus on the paediatric perspective is necessary in providing evidence for good standards of care.

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.

Management of acquired tracheo-oesophageal fistula following intubation

1990 ◽  
Vol 104 (3) ◽  
pp. 267-269 ◽  
Author(s):  
A. E. Camilleri
Keyword(s):  
Tracheal Intubation ◽  
Vocal Cord ◽  
Vocal Cord Palsy ◽  
Subglottic Stenosis ◽  
Left Vocal Cord

AbstractThe management of acquired tracheo-oesophageal fistula due to tracheal intubation is reviewed and a case complicated by left vocal cord palsy and subglottic stenosis is presented. Permanent cricothyroidostomy was used in the management of this original triad of complications.

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