scholarly journals Clinico-etiological Profile of Vocal Cord Paralysis

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.

scholarly journals Vocal cord palsy and getting to know it better

2017 ◽  
Vol 3 (3) ◽  
pp. 621
Author(s):  
Irene Gee Varghese ◽  
Goutham M. K.
Keyword(s):  
Vocal Cord ◽  
Speech Therapy ◽  
Vocal Cord Paralysis ◽  
Vocal Cord Palsy ◽  
Exclusion Criteria ◽  
Number Of Patients ◽  
Underlying Disorder ◽  
A Prospective Study ◽  
Underlying Pathology ◽  
Unilateral Vocal Cord Paralysis

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">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.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">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.</span></p>

scholarly journals Efficacy of Arytenoidectomy after Suture Lateralisation Failure in Patients with Bilateral Vocal Cord Paralysis

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Shinsuke Suzuki ◽  
Takechiyo Yamada
Keyword(s):  
Case Report ◽  
Vocal Cord ◽  
Mucous Membrane ◽  
Vocal Fold ◽  
Vocal Cord Paralysis ◽  
Vocal Fold Paralysis ◽  
Bilateral Vocal Cord Paralysis ◽  
Vocal Function ◽  
Case Methods ◽  
Bilateral Vocal Fold Paralysis

Background. Endolaryngeal suture lateralisation is an ideal operation for bilateral vocal fold paralysis. However, restenosis owing to breakage and slippage of suture can sometimes occur. In such a case, methods that are more effective in expanding the glottis, including arytenoidectomy, must be selected. Case Report. Herein, we report two female patients aged 86 and 54 years who presented with bilateral vocal cord paralysis and who had restenosis after suture lateralisation. Endoscopic partial arytenoidectomy was performed, and satisfactory outcomes were obtained. This method maintains the height of the arytenoid and preserves its sensation by leaving a part of the cartilage and mucous membrane. Conclusion. Endoscopic partial arytenoidectomy is effective for securing the airway while preserving vocal function and preventing aspiration. This technique is suitable for patients with restenosis after they have undergone endolaryngeal suture lateralisation.

Evaluation of Management of Unilateral Vocal Fold Paralysis

1995 ◽  
Vol 112 (5) ◽  
pp. P28-P29
Author(s):  
Maisie L. Shindo ◽  
Peak Woo
Keyword(s):  
Vocal Cord ◽  
Vocal Fold ◽  
Vocal Cord Paralysis ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Educational Objectives ◽  
Vocal Cord Paresis ◽  
Appropriate Treatment

Educational objectives: To understand relevant neuroanatomy and neurophysiology and therefore better identify etiology and pathophysiology of vocal cord paralysis and to systemically and logically evaluate and select appropriate treatment for patients with vocal cord paresis.

scholarly journals HOARSENESS OF VOICE: ETIOLOGICAL SPECTRUM

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Jairaj Kumar Vaishnav
Keyword(s):  
Vocal Cord ◽  
Thyroid Surgery ◽  
Bronchogenic Carcinoma ◽  
Vocal Fold ◽  
Vocal Cord Paralysis ◽  
Vocal Fold Paralysis ◽  
Complex Mechanism ◽  
Voice Production ◽  
Included Patient ◽  
Etiological Spectrum

Background: To evaluate the etiological factors of hoarness Methods: The present study has been carried out in 100 cases of hoarseness were included. Patient with laryngeal and hypopharyngeal malignancy & up to 15 year of age excluded from the study. Results: In the present series bronchogenic carcinoma is the most common etiological factor causing vocal cord paralysis and second is thyroid surgery and third is tuberculosis of lung Conclusion: Voice production is a complex mechanism, involving the muscles of pharynx, palate, tongue, nose and lips. A proper protocol is necessary for identifying the factors responsible for vocal fold paralysis which would help in managing the condition more effectively. Keywords: Vocal cord, Carcinoma, Paralysis.

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.

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 Evaluation of Diffusional Characteristics and Microstructure in Unilateral Vocal Fold Paralysis Using Diffusion Tensor Imaging

2019 ◽  
pp. 014556131987472
Author(s):  
Jie Cai ◽  
Logan Klein ◽  
Pinhong Wu ◽  
Azure Wilson ◽  
Xinlin Xu ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Diffusion Tensor ◽  
Vocal Fold Paralysis ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Unilateral Vocal Fold Paralysis ◽  
Cross Sectional ◽  
Injury Group ◽  
The Cross

Objective: To investigate the value of diffusion tensor imaging (DTI) in the evaluation of vocal fold tissue microstructure after recurrent laryngeal nerve (RLN) injury. Methods: Six canines were divided into 2 groups: a unilateral vocal fold paralysis group (n = 4) and a control group (n = 2). The RLN was cut in the unilateral vocal fold paralysis group, and no intervention was applied in the control group. After 4 months, the canines’ larynges were removed and placed in a small animal magnetic resonance imaging (MRI) system (9.4T BioSpec MRI; Bruker, Germany). After scanning, the vocal folds were isolated, sectioned, and stained. The slides were then analyzed for the cross-sectional area and muscle fiber density through feature extraction technology. Pearson correlation analysis was performed on the DTI scan and histological section extraction results. Results: In the vocal fold muscle layer, the fractional anisotropy (FA) of the unilateral RLN injury group was higher than that of the control group, and the Tensor Trace was lower than that of the control group. This difference was statistically significant, P < .05. In the lamina propria, the FA of the unilateral RLN injury group was lower than that of the control group, P > .05, and the Tensor Trace was lower than that of the control group, P < .05. The muscle fiber cross-sectional area of the RLN injury group was significantly smaller than the control group with statistical significance, P < .05, and the density of muscle fibers was lower, P < .05. The correlation coefficient between FA and the cross-sectional area was −0.838, P = .002, and .726; P = .017 between Tensor Trace and the cross-sectional area. Conclusion: Diffusion tensor imaging is an effective method to assess the changes in the microstructure of atrophic vocal fold muscle tissue after RLN injury.

Vocal fold paralysis following carotid endarterectomy

1999 ◽  
Vol 113 (5) ◽  
pp. 439-441 ◽  
Author(s):  
Fernanda I. Espinoza ◽  
Fiona B. MacGregor ◽  
Julie C. Doughty ◽  
Lynn D. Cooke
Keyword(s):  
Vagus Nerve ◽  
Carotid Endarterectomy ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Indirect Laryngoscopy ◽  
One Year ◽  
Operative Assessment

AbstractInjury to the vagus nerve or one of its branches during carotid endarterectomy (CEA) can result in vocal fold paralysis (VFP). This study assessed prospectively 73 patients undergoing CEA. A total of 76 procedures were performed in these patients over a one-year period. All patients underwent preoperative and post-operative assessment of vocal fold mobility by indirect laryngoscopy and/or flexible nasendoscopy. All patients had normal vocal fold mobility pre-operatively. Eight patients (10 per cent) complained of hoarseness after surgery and in three patients (four per cent) examination confirmed an ipsilateral VFP. This persists in all three patients at six-month follow-up. Vocal fold assessment is important in patients undergoing CEA, particularly when performing second side surgery. We recommend that patients should be informed of the risk of VFP following CEA when obtaining consent.

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