• Title/Summary/Keyword: 성대 마비

Search Result 159, Processing Time 0.022 seconds

Management Principles of Bilateral Vocal Fold Immobility (양측성 성대 마비의 치료 원칙)

  • Kim, Tae-Wook;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.20 no.2
    • /
    • pp.118-125
    • /
    • 2009
  • Bilateral vocal fold immobility (BVFI) is a challenging condition which may result from diverse etiologies including vocal fold paralysis, synkinesis, cricoarytenoid joint fixation, and interarytenoid scar. Most patients present with dyspnea and stridor, but sometimes with a breathy dysphonia. Careful history taking, laryngoscopic evaluation under general anesthesia or awaken status, laryngeal EMG, and imaging studies with CT and/or MRI are helpful for providing a precise diagnosis and planning appropriate managements. In children, congenital neurological disorder is one of the most common etiologies, and spontaneous recovery has been reported in more than 50% of cases. Therefore, observation for more than 6 months while securing the upper airway with tracheostomy if needed is a generally accepted rule before deciding any destructive procedure to be undertaken. In children with advanced posterior glottic stenosis, laryngotracheal reconstruction with rib cartilage graft should be considered. In contrast to children, BVFI most commonly occurs as sequalae of surgical complication in adults. Diverse static or dynamic procedures can be applied; posterior cordotomy, vocal fold lateralization, endoscopic or open arytenoidectomy, arytenoid abduction, and reinnervation, electrical laryngeal pacing, which need to be carefully selected according to each patient's needs and pathophysiology of BVFI.

  • PDF

A Case of Unilateral Vocal Fold Paralysis Caused by Ortner's Syndrome (Ortner's 증후군에 의해 발생한 일측성 성대마비 1예)

  • Park, Sang Hoo;Park, Heon Soo;Bae, Woo Yong;Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.30 no.2
    • /
    • pp.139-141
    • /
    • 2019
  • The causes of vocal cord paralysis include iatrogenic injury during thyroid or cervical surgery, heart and chest surgery, and tumorous lesion such as laryngeal cancer and lung cancer. In addition to these common causes, rarely, cardiovascular disease can also cause vocal fold paralysis. A disease known as Cardiovocal syndrome, or Ortner's syndrome, causes left vocal fold paralysis when the left recurrent laryngeal nerve is compressed by the pulmonary artery and aorta, which is occurred by pulmonary hypertension from heart disease. We report for the first case in Korea the diagnosis of vocal fold paralysis caused by Ortner's syndrome.

Finding Report of Unilateral Vocal Cord Paralysis Using Computed Tomography (컴퓨터단층촬영술을 이용한 수술 후 편측 성대마비의 진단보고)

  • Kim, Minsoo;Seong, Hyun Ho;Kang, Seong Sik;Son, Hee Jeong;Kim, Tae-Hyung;Cheong, Yuseon
    • Journal of radiological science and technology
    • /
    • v.41 no.5
    • /
    • pp.505-509
    • /
    • 2018
  • VCP (Vocal Cord Paralysis) is rare but one of most serious complications related to endotracheal intubation. This report is a clinical experience of radiography and laryngeal EMG (Electromyography) assessment for the VCP. A 50-year-old woman with hoarseness, which was occurred after urethral diverticulum excision was examined by laryngoscopy. As a result of laryngoscopy, VCP was observed in left side of her vocal cord, and then recurrent laryngeal nerve damage was detected with additional CT (Computed tomography) scan and laryngeal EMG. After that, the vocal cord movement was recovered as normal state with regular conservative treatment for the 6 months.

A Case of Bilateral Vocal Fold Paralysis Induced by Concurrent Rheumatoid Arthritis Involvement of Laryngeal Nerve and Cricoarytenoid Joint (윤상피열관절과 후두신경을 동시에 침범하여 양측성대마비를 유발한 류마티스 관절염 1예)

  • Park, Yun Hwi;Kim, Han Su;Jung, Sung Min;Jung, Soo Yeon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.27 no.2
    • /
    • pp.130-133
    • /
    • 2016
  • Rheumatoid arthritis (RA) is a connective tissue disease involving the larynx in 30 % of the patients. Foreign body sensation, hoarseness, and cough are common symptoms in laryngeal involvement. An urgent tracheostomy is required when acute airway obstruction occurs in case of bilateral vocal fold paralysis. The most common cause of bilateral vocal fold paralysis in RA patients is a cricoarytenoid joint arthritis. Laryngeal nerve degeneration is rare cause of bilateral vocal fold paralysis in RA patients. In this case report, an emergent tracheostomy was performed on a 64-years-old male patient with acute dyspnea, and concurrent involvement of RA on laryngeal nerve and cricoarytenoid joint was revealed by laryngeal electromyography and histopathology. The vocal fold mobility was restored after 3-months medical treatment.

  • PDF

A Case of Bilateral Vocal Fold Paralysis from Acromegaly (말단 비대증 환자에서 발생한 양측성대마비 1예)

  • Park, Min-Woo;An, Soo-Youn;Roh, Dong-Hwan;Kwon, Tack-Kyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.20 no.1
    • /
    • pp.68-70
    • /
    • 2009
  • Acromegalic patients can develop mild upper airway obstruction. However, the limitation of both vocal folds mobility developing dyspnea is rare. We report a case with bilateral vocal cord paralysis associated with acromegaly. The patient visited our clinic presenting dyspnea showing bilateral vocal cord hypomobility in laryngoscopy. The patient underwent a tracheostomy and a transsphenoidal resection of the pituitary adenoma. Thereafter, laser cordotomy with medial arytenoidectomy was done for the permanent treatment of glottal obstruction. The tracheotomy canula was successfully removed one month after the surgery.

  • PDF

The Choice of Laryngeal Reinnervation Versus Medicalization Laryngoplasty in Unilateral Vocal Fold Paralysis (일측성 성대 마비의 치료에서 후두 신경재식법과 내측 후두 성형술의 선택)

  • Kim, Heejin
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.31 no.1
    • /
    • pp.1-6
    • /
    • 2020
  • In unilateral vocal fold paralysis (UVFP) patients, we try to improve their symptoms such as hoarseness or aspiration by restoring nerve functions or medialization laryngoplasty (ML), etc. Until now, ML (thyroplasty and/or arytenoid adduction) is considered as gold standard of treatment for UVFP. However, if recurrent laryngeal nerve (RLN) is damaged and use of RLN is feasible during operation, laryngeal reinnervation (LR) would be a good option. Anastomosis with ansa cervicalis to RLN is most common reinnervation method. Delayed LR may be considered in young patients when the RLN denervation period is not long (less than 2 years) for the treatment of surgery-related UVFP. Injection laryngoplasty and laryngeal framework surgery showed great voice outcomes in UVFP. Combination therapy (neuromuscular pedicle innervation with ML) also showed good post-operative voice outcomes even in longer periods (over 2 years). In pediatric patients, LR would be considered as a good treatment option because all procedures need to general anesthesia.

A Case of Unilateral Vocal Fold Paralysis Secondary to Sarcoidosis (사르코이드증에 의한 일측 성대 마비 1예)

  • Lee, Oh-Hyeong;Bang, Jooin;Lee, Dohee;Cho, Jung-Hae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.30 no.1
    • /
    • pp.61-64
    • /
    • 2019
  • Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Vocal fold paralysis secondary to sarcoidosis is extremely rare but it can develop as a result of compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We report the case of a 56-year-old woman who presented with unilateral vocal fold paralysis and enlarged supraclavicular lymph nodes. Computed tomography of the neck revealed multiple, enlarged, and matted lymph nodes at the cervical level of IV. An ultrasound-guided core needle biopsy of the lymph node was performed, and a histopathological diagnosis of sarcoidosis was made by validating the presence of noncaseating granuloma. After implementation of steroid therapy, the patient exhibited immediate recovery from vocal fold paralysis. Although an extremely rare disease, sarcoidosis should be included in the differential diagnosis of vocal fold paralysis. Accurate diagnosis and prompt steroid treatment may reduce the morbidity of patients with vocal fold paralysis secondary to sarcoidosis.

A Case of Recurred Herpes Zoster Oticus Concomitantly Occurred with Zoster Laryngopharyngitis Without Vocal Cord Palsy (재발성 이성대상포진과 동반된 성대마비 없는 대상포진 인후두염 1예)

  • Cha, Eun Joo;Jung, Yu Jin;Cho, Hyun Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.30 no.1
    • /
    • pp.65-68
    • /
    • 2019
  • Herpes zoster oticus is one of complication of varicella zoster virus (VZV) reactivation in the geniculate ganglion of the facial nerve, which is the most common presentation of herpes zoster in the head and neck region. However, VZV infection of the larynx has rarely been described in the literature compared with Herpes zoster oticus. Moreover, zoster laryngopharyngitis simultaneously occurred with recurred Herpes zoster oticus which has no newly developing motor dysfunction has not been reported yet. Therefore, these diseases are difficult to diagnose due to its rareness. However, distinctive appearances such as unilateral herpetic mucosal eruptions and vesicles are useful and essential in making a quick and accurate diagnosis. Thus, we report a characteristic case of zoster laryngopharyngitis simultaneously occurred with recurred Herpes zoster oticus not accompanied by any newly developing motor palsy.