• Title/Summary/Keyword: Bilateral vocal cord palsy

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Nerve-Muscle Pedicle Reinnervation in Bilateral Vocal Cord Palsy (양측성 성대마비에서의 신경-근 이식 수술)

  • 우훈영;김영기;정현수
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.6 no.1
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    • pp.5-8
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    • 1995
  • Bilateral vocal cord palsy is uncommon but is serious because of airway obstruction. Treatments of bilateral vocal cord palsy are initially tracheotomy, vocal cord lateralization and vocal cord reinnervation. Recently, we experienced nerve-muscle pedicle reinnervation in 3 cases of bilateral vocal cord palsy, so reported it with a review of literature.

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Bilateral Vocal Cord Paralysis : A 10-year Review of 42 Patients (양측성대마비의 10년간 경험 분석)

  • 김광문;김세헌;최홍식;최흥식;조정일;이준협
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.1
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    • pp.75-81
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    • 1997
  • The clinical investigation was done in the 42 patients with bilateral vocal cord palsy who visited the otorhinolaryngologic department of the Yongdong Severance Hospital during the 10-year period between August 1986 to August 1996. On the sex and age distribution, the ratio of male to female patients was 2.8 : 1 and the age was evenly distributed and average was 46 years old. Of their chief complaints, dyspnea was the most common symptom. Among the position of the paralyzed vocal cords, paramedian position was most common. The most common causes of the bilateral vocal cord palsy was idiopathic Other causes include iatrogenic, prolonged intubation, head & neck trauma, brain tumor, Myasthenia Gravis, and mediastinitis. Our treament results were as follows. Recovery rate of idiopathic bilateral vocal cord palsy was 77.7% and recovery period after bilateral vocal cord palsy was shortened remarkedly after use with steroid. We performed laser arytenoidectomy in patients with irreversible idiopathic vocal cord palsy, neural injury, and cricoarytenoid joint fixation. Decannualtion was possible to be carried out in 86% of the patients and none of complication except for 1 case of aspiration developed. Thus we concluded that it was meaningful surgical treatment of bilateral vocal cord palsy.

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Management of Bilateral Vocal Cord Palsy (양측성 성대 마비의 치료)

  • Ryu, In Sun;Choi, Seung-Ho
    • Korean Journal of Bronchoesophagology
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    • v.19 no.1
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    • pp.5-10
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    • 2013
  • Bilateral vocal cord palsy (BVCP) present a challenging condition which result from various etiologies including iatrogenic recurrent laryngeal nerve injury, progressive neurological disorder, intubation, trauma, tumor and idiopathic cause. Careful history taking, laryngoscopic evaluation, laryngeal EMG, and imaging studies are helpful for providing a precise diagnosis and planning appropriate treatment. BVCP causes airway restriction and not vocal dysfunction. In patients with BVFP, treatment is directed at maximizing the airway, while attempting to limit the negative effects of treatment on vocal function. A variety of surgical procedures are available for mangement of BVCP. The most conservative, limited procedure should be selected initially, and then further surgery and more extensive surgery can be tailored to the patient's airway and voice needs. This review will address the etiology, diagnosis, and managements of BVCP.

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A Case of Interarytenoid Scar Disguising Bilateral Vocal Cord Palsy (양측성 성대 마비로 오인된 피열간 반흔 1예)

  • Shin, Dong-Hyuk;Kim, Yong Won;Lee, Yongsik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.1
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    • pp.36-38
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    • 2014
  • The patient suffered cardiac arrest 8 months before presentation. She has been suffering hoarseness and exertional dyspnea and nocturnal stridor. Upon flexible laryngoscopy, her vocal cords showed no motion and fixed in paramedian position. There was no causal finding on neck CT. EMG showed some muscular activity. Under the suspicion of crico arytenoid fixation, we performed suspension laryngoscopy, and found the arytenoid cartilage was fixed with short and stout scar, which was removed with scissors. Just after surgery she regained her voice and respiration.

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A Case of Relapsing Polychondritis (기도협착이 초래된 재발성 다발연골염 1례)

  • 최홍식;김현준;박준호;김진영
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.2
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    • pp.149-153
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    • 1999
  • Relapsing polychondritis is an uncommon disorder of unknown etiology. That involves multisystem characterized by recurrent inflammation, degenerative change of multiple cartilaginous structures. The most common clinical manifestation is an auricular chondritis. Other involving systems are joint, nose, eye, larynx, trachea, aorta, heart and kidney. A 26-year-old man who complained of hoarseness and sore throat was referred to the ENT department from internal medicine department. On initial video-laryngoscopic and radiologic examination, there was no abnormal finding. Treatment with high doses of corticosteroid and methotrexate was not effective. Symptoms were aggrevated with dyspnea. Three months later, on video-laryngoscopic examination, bilateral cord fixation with swelling was noted. The radiologic finding showed subglottic stenosis due to collapse of anterior wall of cricoid cartilage. The condition was managed with tracheotomy. We report a case of relapsing polychondritis involving larynx and trachea with bilateral vocal cord palsy which was managed with tracheotomy.

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A Case of Successful Use of C-MAC® Video Laryngoscope in 'Cannot Ventilate' Situation Due to Unexpected Severe Narrowing of Laryngeal Inlet (예기치 못한 후두 입구 협착으로 인한 환기 부전 상황에서의 비디오 후두경의 유용성 1예)

  • Moon, Jeong Hwan;Lee, Sun Hong;Kang, Bong Jin
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.122-125
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    • 2016
  • Although many factors associated with difficult intubation have been known, predictors of difficult mask ventilation are not well known. We experienced a case of nearly complete airway obstruction following usual anesthetic induction which needed various emergency treatments. The patient had a preoperative diagnosis of contact granuloma of right posterior vocal cord and bilateral vocal cord palsy but later was found out as invasive laryngeal cancer. Upon the surgical field of view, both vocal cords were showing significantly thickened and fixated appearance and was considered as in the critical narrowing state with the potential of complete obstruction. Using $C-MAC^{(R)}$ video laryngoscope we were able to see the narrowed vocal cord and choose proper size of endo-tracheal tube. Consequently, intubation was successfully done and operation was conducted. From this case, we have lessons that physicians should examine the patient's airway more carefully in case of laryngeal mass and prepare emergency measures.

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A Case of Functional Recovery of the Postoperative Bilateral Vocal Cord Paralysis in Papillary Thyroid Carcinoma with Rt. Recurrent Laryngeal Nerve Invasion (우측 반회후두신경을 침범한 갑상선 유두상암 환자의 수술 후 발생한 양측 성대 마비의 회복 1예)

  • Mun, Mi Jin;Wang, Soo Geun;Lee, Yoon Se;Lim, Yun-Sung;Lee, Jin Chun;Kang, Yang Ho;Son, Seok Man;Kim, In Joo
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.53-56
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    • 2011
  • Vocal cord paralysis (VCP) is a common complication after thyroidectomy despite the continuity of the recurrent laryngeal nerve (RLN) is preserved. Much efforts have been made into preventing VCP, but few of them focuses on the treatment strategies and prognosis after VCP take place. In this case, patient visited the clinic for papillary thyroid cancer in Rt. thyroid gland without VCP. She underwent total thyroidectomy with central neck dissection. During dissection, Rt main mass was encircling Rt. RLN. To make matters worse, Lt. RLN was severed due to tight attachment with Berry's ligament. After that, intratumoural dissection of Rt. RLN and end to end anastomosis of Lt. RLN were performed with microscopy to preserve the functions of RLNs as much as possible, otherwise permanent bilateral VCPs were inevitable. We report this case, since both vocal cords recovered from VCPs with symmetric, synchronous movements at postoperative follow up.

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Neuro-muscular Pedicle Graft in Bilateral Vocal Cord Palsy (신경-근 이식을 통한 양측성 성대마비의 치료)

  • 우훈영;정현수;김영기
    • Proceedings of the KSLP Conference
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    • 1994.06b
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    • pp.89-89
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    • 1994
  • 양측성 성대마비의 수술적 치료는 여러 가지가 알려져 있으나 원인을 알 수 없는 양측성 성대마비인 경우 견갑설골근과 경계제신경을 이용한 신경-근 이식으로 좋은 결과를 얻을 수 있는 것으로 알려져 있다. 저자들은 양측성 성대마비 환자 3례를 신경-근 이식을 이용하여 수술하였기에 보고하는 바이다. (중략)

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A Case of Parahilar Lymph Node Enlargement (폐문부의 림프절 종대 1예)

  • Lee, Hee Jung;Son, Ji Woong;Choi, Eugene;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.209-212
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    • 2005
  • Sarcoidosis, a multisystemic granulomatous disorder of unknown causes, which presents with bilateral hilar adenopathy, pulmonary infiltration, and cutaneous, ocular, bones, and nervous and reticuloendothelial systems involvement, commonly involves young adults of both sexes. Herein, the case of a 70-year-old male, with progressive hoarseness of two weeks' duration and mild dyspnea, is reported. A fiberoptic bronchoscopy, performed to investigate the hoarseness, revealed paralysis of the left vocal cord, but with no other local abnormality. Two nodules, as pathologic findings, showed noncaseating epithelioid cell granulomas. We note a rare case of sarcoidosis, with vocal cord palsy, in Korea.

Comparison of Clinical Characteristics Between Patients With Different Causes of Vocal Cord Immobility

  • Kim, Min-Hyun;Noh, Junsoo;Pyun, Sung-Bom
    • Annals of Rehabilitation Medicine
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    • v.41 no.6
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    • pp.1019-1027
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    • 2017
  • Objective To analyze the clinical characteristics between neurogenic and non-neurogenic cause of vocal cord immobility (VCI). Methods The researchers retrospectively reviewed clinical data of patients who underwent laryngeal electromyography (LEMG). LEMG was performed in the bilateral cricothyroid and thyroarytenoid muscles. A total of 137 patients were enrolled from 2011 to 2016, and they were assigned to either the neurogenic or non-neurogenic VCI group, according to the LEMG results. The clinical characteristics were compared between the two groups and a subgroup analysis was done in the neurogenic group. Results Among the 137 subjects, 94 patients had nerve injury. There were no differences between the neurogenic and non-neurogenic group in terms of demographic data, underlying disease except cancer, and premorbid events. In general characteristics, cancer was significantly higher in the neurogenic group than non-neurogenic group (p=0.001). In the clinical findings, the impaired high pitched 'e' sound and aspiration symptoms were significantly higher in neurogenic group (p=0.039 for impaired high pitched 'e' sound; p=0.021 for aspiration symptoms), and sore throat was more common in the non-neurogenic group (p=0.014). In the subgroup analysis of neurogenic group, hoarseness was more common in recurrent laryngeal neuropathy group than superior laryngeal neuropathy group (p=0.018). Conclusion In patients with suspected vocal cord palsy, impaired high pitched 'e' sound and aspiration symptoms were more common in group with neurogenic cause of VCI. Hoarseness was more frequent in subjects with recurrent laryngeal neuropathy. Thorough clinical evaluation and LEMG are important to differentiate underlying cause of VCI.