scholarly journals Bilateral vocal fold paralysis after COVID-19 infection. Another neuro-invasive manifestation? Case series

2021 ◽  
Author(s):  
Juan José Correa Barrera ◽  
Blanca Gómez del Pulgar Vázquez ◽  
Adriana Orozco Vinasco ◽  
Purificación Sánchez Zamora ◽  
Sonia Sánchez Solano ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Vocal Fold ◽  
Viral Infections ◽  
Case Series ◽  
Vocal Fold Paralysis ◽  
Viral Origin ◽  
Bilateral Vocal Fold Paralysis ◽  
The Central Nervous System ◽  
Short And Long Term

The agent that causes the coronavirus disease (COVID-19), associated with the severe acute respiratory syndrome (SARS-CoV-2), produces a spectrum of symptoms that mainly affect the respiratory system, the central nervous system (CNS), the regulation of hemostasis and the immune system. Bilateral vocal fold paralysis (BVFP) is a condition of unknown incidence among infected patients, either because it is short-lived or because of the difficulty in establishing a direct cause to the virus. Viral infection has been described in the literature as a cause of BVFP and there is the suspicion that a proportion of the idiopathic cases are due to undiagnosed viral infections. Although the neurotropic mechanisms for SARS-CoV-2 remain unclear, there is strong evidence to ensure its neuroinvasive potential. The most frequent etiologies of BVFP are trauma, neoplasm, and neurological, but a viral origin should not be ruled out. Causality between COVID-19 and BVFP is plausible and will require further study in the short and long term.

Reduction in Short- and Long-term Pneumonia Rate With Laryngoplasty for Unilateral Vocal Fold Paralysis

2021 ◽  
pp. 019459982110151
Author(s):  
Cheng-Ming Hsu ◽  
Yao-Te Tsai ◽  
Geng-He Chang ◽  
Yao-Hsu Yang ◽  
Tuan-Jen Fang ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Vocal Fold ◽  
Proportional Hazards ◽  
Vocal Fold Paralysis ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Voice Therapy ◽  
Unilateral Vocal Fold Paralysis ◽  
Short And Long Term

Objective To examine the association of laryngoplasty, voice therapy, and pneumonia rate in patients with unilateral vocal fold paralysis (UVFP). Study Design Population-based retrospective cohort study. Setting Data were collected from the LHID2000 (Longitudinal Health Insurance Database 2000), containing the information of 1 million randomly selected patients in Taiwan. Methods In the LHID2000, we identified 439 patients having new diagnoses of UVFP from 1997 to 2013. We grouped the aforementioned patients according to UVFP treatment and probed the occurrence of pneumonia: 305 patients underwent laryngoplasty or voice therapy, and 134 patients did not undergo treatment. Follow-up procedures were executed for the enrollees until death or December 31, 2013, representing the end of the study period. We assessed the association of UVFP treatment and pneumonia by executing Cox proportional hazards regression. Results The pneumonia cumulative incidence was significantly higher among enrolled patients without treatment than in those receiving treatment ( P < .001). The pneumonia incidence was significantly lower in patients receiving UVFP treatment (hazard ratio, 0.49; 95% CI, 0.27-0.88; P = .018), as validated by the Cox proportional hazards model after adjustment. Patients undergoing laryngoplasty with or without voice therapy had a significantly lower incidence of pneumonia at 6 months and 1, 3, and 5 years, whereas those undergoing voice therapy alone did not. Conclusion Laryngoplasty was associated with a lower incidence of short- and long-term pneumonia in patients with UVFP. Physicians should encourage patients with UVFP at risk of aspiration to receive prompt evaluation as well as treatment.

Long-Term Results of Nerve-Muscle Pedicle Reinnervation for Laryngeal Paralysis

1989 ◽  
Vol 98 (9) ◽  
pp. 674-676 ◽  
Author(s):  
Harvey M. Tucker
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Long Term Results ◽  
Bilateral Group ◽  
Bilateral Vocal Fold Paralysis ◽  
Cricoarytenoid Arthritis ◽  
Nerve Muscle ◽  
Unilateral Group

Between 1976 and 1986, 214 patients with bilateral vocal fold paralysis and 73 patients with unilateral vocal fold paralysis were managed by the author using the nerve-muscle pedicle technique for reinnervation. Follow-up of at least 2 years has been obtained on 202 of the bilaterally and 70 of the unilaterally involved patients. Long-term success has been achieved in 74% of the bilateral group and 88% of the unilateral group. Successful reinnervation of unilateral paralyses usually maintains voice correction indefinitely, but there is late (2 to 5 years postsurgery) deterioration of successful airway restoration in approximately 17% of bilateral cases, which appears to be due to development of cricoarytenoid arthritis.

Mechanical failure of the Mobi-C implant for artificial cervical disc replacement: report of 4 cases

2020 ◽  
Vol 33 (6) ◽  
pp. 727-733
Author(s):  
Jasmine A. T. DiCesare ◽  
Alexander M. Tucker ◽  
Irene Say ◽  
Kunal Patel ◽  
Todd H. Lanman ◽  
...  
Keyword(s):  
Cervical Spondylosis ◽  
Case Series ◽  
Dynamic Imaging ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Artificial Disc ◽  
Younger Patients ◽  
Cervical Disc Replacement ◽  
Short And Long Term

Cervical spondylosis is one of the most commonly treated conditions in neurosurgery. Increasingly, cervical disc replacement (CDR) has become an alternative to traditional arthrodesis, particularly when treating younger patients. Thus, surgeons continue to gain a greater understanding of short- and long-term complications of arthroplasty. Here, the authors present a series of 4 patients initially treated with Mobi-C artificial disc implants who developed postoperative neck pain. Dynamic imaging revealed segmental kyphosis at the level of the implant. All implants were locked in the flexion position, and all patients required reoperation. This is the first reported case series of symptomatic segmental kyphosis after CDR.

scholarly journals Self-buffering capacity of a human sulfatase for central nervous system delivery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yi Wen ◽  
Nazila Salamat-Miller ◽  
Keethkumar Jain ◽  
Katherine Taylor
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Buffering Capacity ◽  
The Self ◽  
High Concentration ◽  
Formulation Design ◽  
The Central Nervous System ◽  
Therapeutic Enzymes ◽  
Intrathecal Space

AbstractDirect delivery of therapeutic enzymes to the Central Nervous System requires stringent formulation design. Not only should the formulation design consider the delicate balance of existing ions, proteins, and osmolality in the cerebrospinal fluid, it must also provide long term efficacy and stability for the enzyme. One fundamental approach to this predicament is designing formulations with no buffering species. In this study, we report a high concentration, saline-based formulation for a human sulfatase for its delivery into the intrathecal space. A high concentration formulation (≤ 40 mg/mL) was developed through a series of systematic studies that demonstrated the feasibility of a self-buffered formulation for this molecule. The self-buffering capacity phenomenon was found to be a product of both the protein itself and potentially the residual phosphates associated with the protein. To date, the self-buffered formulation for this molecule has been stable for up to 4 years when stored at 5 ± 3 °C, with no changes either in the pH values or other quality attributes of the molecule. The high concentration self-buffered protein formulation was also observed to be stable when exposed to multiple freeze–thaw cycles and was robust during in-use and agitation studies.

Dual laryngeal reinnervation in bilateral vocal fold paralysis: anatomical pitfalls

2021 ◽  
Vol 43 (11) ◽  
pp. 1745-1751
Author(s):  
Jean Michel Prades ◽  
Yann Lelonge ◽  
Marie Dominique Dubois ◽  
Jean Marc Dumollard ◽  
Michel Peoc’h ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Bilateral Vocal Fold Paralysis ◽  
Laryngeal Reinnervation
Sign in / Sign up

Export Citation Format

Share Document