Frequency of Vocal Cord Paralysis in Thyroidectomy

Back ground: Recurrent laryngeal nerves being adjacent to the thyroid glands are prone to surgical trauma by thyroid surgery done for thyroid disease leading to vocal cord paralysis. Aim: To determine frequency of vocal cord paralysis in thyroidectomy Methodology: This is a descriptive cases series was completed in 6 months [December 4, 2019 till June 4, 2020] at Department ENT, Sir Ganga Ram hospital Lahore. The sample technique used is non-probability consecutive sampling .All 170 patients meeting inclusion criteria were inducted in the study from ENT SGR hospital, Lahore. Results: The mean age of all patients was 39.52±11.30 years with minimum and maximum age as 20 and 60 years. There were 91(53.5%) cases that were 20-40 years old and 79(46.5%) cases were 41-60 years old. There were 62(36.5%) male and 108(63.5%) female cases with higher female to male ratio. In 96(56.5%) cases left side and in 74(43.5%) cases right side was involved. There were 37(21.8%) who had vocal cord paralysis while 133(78.2%) cases did not have vocal cord paralysis. Conclusion: It is concluded that high number of patients i.e. 21.8% had vocal cord paralysis, so in future ENT surgeons should adopt safety measures for prevention of VCP such anatomical considerations of the sensitive area Keywords: ENT, thyroidectomy, complications, vocal cord paralysis

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Vocal cord paralysis as a presenting sign of autosomal recessive spinocerebellar atrophy type 10

BMJ Case Reports ◽

10.1136/bcr-2021-245484 ◽

2021 ◽

Vol 14 (12) ◽

pp. e245484

Author(s):

David Vaughan ◽

Adrinda Affendi ◽

Patrick Sheahan ◽

Brian Sweeney

Keyword(s):

Vocal Cord ◽

Autosomal Recessive ◽

Vocal Cord Paralysis ◽

Recessive Mutation ◽

Speech Disturbance ◽

Laryngeal Nerves ◽

Recessive Type ◽

Autosomal Recessive Mutation ◽

Recurrent Laryngeal Nerves ◽

Spinocerebellar Atrophy

Acquired vocal cord paralysis (VCP) is caused by dysfunction or injury of one or both recurrent laryngeal nerves. Here we report a 41-year-old man with spinocerebellar atrophy, autosomal recessive type 10 (SCAR10) due to an autosomal recessive mutation in the ANO10 gene, with VCP as the presenting symptom. He later developed ataxia and speech disturbance.

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S183 – Intracordal Fat Assessment after Injection Laryngoplasty

Otolaryngology ◽

10.1016/j.otohns.2008.05.357 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P137-P137

Author(s):

Tuan-Jen Fang ◽

Chao-Jan Wang ◽

Hsueh-Yu Li

Keyword(s):

Vocal Cord ◽

Vocal Cord Paralysis ◽

Upper Airway ◽

Fat Injection ◽

Long Term Outcomes ◽

Autologous Fat ◽

The Mean ◽

Fat Volume ◽

Unilateral Vocal Cord Paralysis

Objectives Autologous fat injection for unilateral vocal cord paralysis is a popular procedure for immediate symptoms control, but uneven long-term outcomes were reported. Most authors believed that the continual resorption of injected fat was the cause of voice degradation. A long-term residual fat volume was evaluated. Methods We retrospectively reviewed the patients following autologous fat injection for symptomatic unilateral vocal cord paralysis from 2002 Aug to 2006 July. The patients accepted head and neck computed tomogragphy (CT) evaluation following surgery were included. A three-dimensional reconstruction of the images of larynx and upper airway was performed on the work station (Vitrea® 2, version 3.9). The volume of intracordal fat was then calculated. Results 5 males and 15 females of the mean age 49 were enrolled. The mean duration from lipoinjection surgery to the CT study is 23.0 months (12–50 months). The injection fat was found in all study cases. The estimated fat volume ranged from 0.01 to 0.75 ml with a mean 0.33 ml. Compare with the injected fat volume, a mean 27.5% fat survived. The correlation between residual fat volume rate and duration of follow-up is not significant. Conclusions The intracordal fat volume didn't decline from time. Long-term intracordal injected fat diminished but survived in all cases. The degradation may be caused by absorption or immediate extrusion from injection wound. An over-correction and prevention of extrusion postoperatively would improve the long-term outcomes.

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Is Vocal Cord Assessment before Total Thyroidectomy Required for All Patients?

The American Surgeon ◽

10.1177/000313481908501134 ◽

2019 ◽

Vol 85 (11) ◽

pp. 1265-1268

Author(s):

Birkan Birben ◽

Sabri Özden ◽

Sadettin Er ◽

Bariş Saylam

Keyword(s):

Total Thyroidectomy ◽

Vocal Cord ◽

Vocal Cord Paralysis ◽

Univariate Analysis ◽

Neck Surgery ◽

Indirect Laryngoscopy ◽

Surgical History ◽

History Of ◽

Independent Variable ◽

The Mean

We investigated whether laryngoscopy should be performed before total thyroidectomy on all patients without a history of neck surgery. A total of 2523 patients who underwent total thyroidectomy between January 1, 2013, and March 18, 2018, were retrospectively examined. Pre-operative vocal cord examination was performed on 2070 of these patients by the otorhinolaryngology department using indirect laryngoscopy. Patients with a history of neck or thyroid surgery were not included in the study. The patients were evaluated in terms of age, gender, symptom (hoarseness/dyspnea), comorbidity, surgical history, biopsy, nodule diameter, pathological diagnosis, and tracheal deviation. Preoperative vocal cord paralysis was detected in 0.8 per cent of the patients (17/2070). Four patients (23.5%) were male and 13 patients (76.5%) were female. The mean age was 62 (range, 25–82) years. Seven of the 17 patients (41%) were symptomatic, with complaints of dyspnea in five and hoarseness in two. The univariate analysis revealed that a nodule diameter >30 mm and the presence of dyspnea were associated with vocal cord damage. Furthermore, the multivariate analysis showed that dyspnea alone was an independent variable ( P = 0.011). It is recommended that preoperative vocal cord evaluation should be performed only in patients with severe symptoms, such as dyspnea.

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Vocal cord paralysis associated with anterior cervical fusion: considerations for prevention and treatment

Journal of Neurosurgery ◽

10.3171/jns.1985.62.5.0657 ◽

1985 ◽

Vol 62 (5) ◽

pp. 657-661 ◽

Cited By ~ 96

Author(s):

Richard F. Bulger ◽

James E. Rejowski ◽

Robert A. Beatty

Keyword(s):

Vocal Cord ◽

Nerve Palsy ◽

Vocal Cord Paralysis ◽

Superior Laryngeal Nerve ◽

Surgical Anatomy ◽

Laryngeal Nerve ◽

Surgical Trauma ◽

Content Type ◽

Laryngeal Nerve Palsy ◽

Long Term Follow Up

✓ In a series of 375 patients with anterior cervical fusions, long-term follow-up results complete with laryngeal examination were obtained in 102 patients. One patient was found to have an inferior laryngeal nerve palsy, and one had a superior laryngeal nerve palsy. Both deficits were thought to be the result of surgical trauma. Measures to minimize the incidence of vocal cord paralysis include careful surgical technique and knowledge of the surgical anatomy of the laryngeal nerves. Suggestions are given for the assessment of postoperative hoarseness, and for the management of vocal cord paralysis.

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Contemporary Evaluation of Unilateral Vocal Cord Paralysis

Otolaryngology ◽

10.1177/019459989210700113 ◽

1992 ◽

Vol 107 (1) ◽

pp. 84-90 ◽

Cited By ~ 82

Author(s):

David J. Terris ◽

David P. Arnstein ◽

Henry H. Nguyen

Keyword(s):

Cost Effectiveness ◽

Vocal Cord ◽

Vocal Cord Paralysis ◽

Chest Roentgenogram ◽

Common Finding ◽

Surgical Trauma ◽

Common Cause ◽

Evaluation Protocol ◽

Cost Efficient ◽

Unilateral Vocal Cord Paralysis

Unilateral vocal cord paralysis is a common finding in the practice of otolaryngology. Multiple etiologies have been described and have not changed appreciably in the last century. We attempted to characterize the contemporary evaluation of unilateral vocal cord paralysis, with consideration given to cost-effectiveness. Thirty-one board-certified otolaryngologists were interviewed to determine their typical evaluation protocol. The average cost of an evaluation totaled $1706.18, with a range of $112.56 to $3439.52. Otolaryngologists with more years of experience tended to pursue briefer and less expensive evaluations. The charts of 187 patients with a diagnosis of vocal paralysis from 1983 to 1991 were reviewed, of which 113 were evaluable. Eighty-four of these 113 (74%) were unilateral. In 48 of 84 cases (57%), the cause was apparent at the time of diagnosis. In 36 of 84 cases (43%), an evaluation was necessary. A diagnosis was achieved in 27 of these 36 instances (75%), with the most useful test being a chest roentgenogram ( n = 13, 48%). The most common cause of unilateral vocal cord paralysis in our series was neoplasm ( n = 34, 40%), followed by surgical trauma ( n = 29, 35%). In no instance was a malignancy discovered subsequent to the initial evaluation. The most cost-efficient, inclusive diagnostic evaluation of unilateral vocal cord paralysis involves a stepwise progression through the tests that are most likely to yield a diagnosis, with endoscopy reserved for those cases in which simpler, less invasive tests have not indicated a cause.

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Sarcoidosis Presenting as Bilateral Vocal Cord Paralysis From Bilateral Compression of the Recurrent Laryngeal Nerves From Thoracic Adenopathy

Journal of Voice ◽

10.1016/j.jvoice.2008.01.009 ◽

2009 ◽

Vol 23 (5) ◽

pp. 631-634 ◽

Cited By ~ 12

Author(s):

Charles S. Coffey ◽

Stacey L. Vallejo ◽

Emily K. Farrar ◽

Marc A. Judson ◽

Lucinda A. Halstead

Keyword(s):

Vocal Cord ◽

Vocal Cord Paralysis ◽

Bilateral Vocal Cord Paralysis ◽

Laryngeal Nerves ◽

Recurrent Laryngeal Nerves

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Vocal cord palsy and getting to know it better

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20173035 ◽

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

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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Stereotactic radiosurgery in patients with glomus jugulare tumors

Neurosurgical FOCUS ◽

10.3171/foc.2004.17.2.10 ◽

2004 ◽

Vol 17 (2) ◽

pp. 63-67 ◽

Cited By ~ 64

Author(s):

Bruce E. Pollock

Keyword(s):

Hearing Loss ◽

Vocal Cord ◽

Gamma Knife ◽

Cranial Nerve ◽

Vocal Cord Paralysis ◽

Gamma Knife Surgery ◽

Glomus Jugulare ◽

The Mean ◽

Primary Management

Object Microsurgical removal of glomus jugulare tumors is frequently associated with injury of the lower cranial nerves. To decrease the morbidity associated with tumor management in these patients, gamma knife surgery (GKS) was performed as an alternative to resection. Methods Between 1990 and 2003, 42 patients underwent GKS as the primary management (19 patients) or for recurrent glomus jugulare tumors (23 patients). Facial weakness and deafness were more common in patients with recurrent tumors than in those in whom primary GKS was performed (48% compared with 11%, p = 0.02). The mean tumor volume was 13.2 cm3; the mean tumor margin dose was 14.9 Gy. The mean follow-up period for the 39 patients in whom evaluation was possible was 44 months (range 6–149 months). After GKS, 12 tumors (31%) decreased in size, 26 (67%) were unchanged, and one (2%) grew. The patient whose tumor grew underwent repeated GKS. Progression-free survival after GKS was 100% at 3 and 7 years, and 75% at 10 years. Six patients (15%) experienced new deficits (hearing loss alone in three, facial numbness and hearing loss in one, vocal cord paralysis and hearing loss in one, and temporary imbalance and/or vertigo in one). In 26 patients in whom hearing could be tested before GKS, hearing preservation was achieved in 86 and 81% at 1 and 4 years posttreatment, respectively. No patient suffered a new lower cranial nerve deficit after one GKS session; the patient in whom repeated GKS was performed experienced a new vocal cord paralysis 1 year after his second procedure. Conclusions Gamma knife surgery provided tumor control with a low risk of new cranial nerve injury in early follow-up review. This procedure can be safely used as a primary management tool in patients with glomus jugulare tumors that do not have significant cervical extension, or in patients with recurrent tumors in this location.

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