• Title/Summary/Keyword: Bilateral vocal paralysis

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Medial Partial Arytenoidectomy by $CO_2$laser for Bilateral Vocal Cord Paralysis (양측 성대마비 환자에 대한 $CO_2$레이저 피열연골 내측부분절제술)

  • 최홍식;최영준;이용훈;박헌이
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.219-224
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    • 1998
  • Bilateral vocal cord paralysis can result in severe airway compromise. Over the years a variety of arytenoidectomy procedures have bee described, and one or more of these have been the gold standard for many years. A widely accepted treatment is endoscopic laser total arytenoidectomy. However, vocal results are usually poor. Objective : To evaluate the effect of treatment of endoscopic laser medial partial arytenoidectorny for bilateral vocal cord paralysis Material and Methods : We performed endoscopic medial partial arytenoidceomy with $CO_2$laser for 3 patients with bilateral vocal cord paralysis. The $CO_2$laser is operated with a continuous 7-watt beam in superpulse mode. We compared degree of dyspnea and glottic area of pre-operation with those of post-operation for 3 patients. We analysed aerodynamic study pre-operatively and post-operatively for 1 patient. Results The symptom of dyspnea was improved markedly and the glottic area was widened from 34% to 50% compared with that of pre-operation. The voice quality was slightly decreased. Tracheotomy was not necessary for not-tracheotomized patient and decanulation was possible for tracheotomized patient post-operatively. Cunclusion: The endoscopic laser medial partial arytenoidectomy is a convient and effective method for opening the posterior glottic airway.

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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
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    • v.27 no.2
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    • pp.130-133
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    • 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.

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A Case of Voice Therapy for Post-Thyroidectomy Syndrome (갑상선 수술 후 양측성 성대마비 환자의 음성치료 1예)

  • Kang, Young Ae;Song, Kun Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.45-49
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    • 2022
  • Post-thyroidectomy syndrome refers to various voice changes experienced after the thyroid surgery. Among them, surgery or injection therapy has been prioritized over voice therapy for the bilateral vocal cord paralysis. However, if it is possible to determine whether voice therapy can be applied first, a faster treatment recovery will be possible. In this study, voice therapy was performed on a 59-year-old female patient with bilateral vocal cord paralysis after total thyroidectomy. This study is to presents the criteria for applying the voice therapy first for bilateral vocal folds paralysis and to share successful voice therapy sessions.

Arytenoidopexy with Bilateral Vocal Cord Excision (laryngofissure) for the Relief of Laryngeal Paralysis (후두마비 개에 대한 피열연골고정술)

  • 연성찬;남치주;권오경
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.185-194
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    • 1997
  • This study was conducted to assess the application of spectrograms in the diagnosis of laryngeal paralysis and the arytenoidopexy with bilateral vocal cord excision (laryngofissure) for the relief of laryngeal paralysis. Laryngeal paralysis represented two types of stridor A and B (AN, PN). There were significant differences in Dominant Frequency ( DF, p<0.01), which were $3590{\pm} 209.81 Hz, 7445\{pm}418.54 Hz$, respectively. After arytenoidopexy with bilateral vocal cord excision (laryngofissure), $PaO_{2} levels (100.57{\pm}7.59 mmHg) were more increased than that (86.5 {\pm} 3.34 mmHg)$ of pre-operative dogs.

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Vocal Fold Paralysis Following General Anesthesia with Endotracheal Intubation (기관내 삽관에 의한 전신 마취 후 발생된 성대 마비)

  • 정성민;이재연;장주애;구태완
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.2
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    • pp.130-134
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    • 1999
  • Background and Objectives : Vocal fold paralysis is an unusual complication following endotracheal intubation. We experienced five cases and analyzed their causes and preventions. Materials and Methods : We reviewed 5 cases of vocal fold paralysis following general anesthesia with endotracheal intubation at Ewha Womans University Hospital from September 1997 to May 1999 retrospectively. Results : Four cases were unilateral vocal fold paralysis(3 cases were left side, 1 case was right side) and a case was bilateral vocal fold paralysis. Conclusion : Vocal fold paralysis following endotracheal intubation is the result of recurrent laryngeal nerve damage. This damage can occur as the result of compressing the anterior branch of recurrent laryngeal nerve between an inflated endotracheal tube cuff and thyroid cartilage. Prevention of this complication lies in eliminating the use of endotracheal tubes with cuff inflated unevenly, desisting from the practice of deliberately placing the cuff within the larynx, and filling the cuff with a sample of the inspired mixture of gases.

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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
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    • v.20 no.1
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    • pp.68-70
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    • 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.

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A Case of Nonsyndromic Intrahepatic Bile Duct Paucity with Congenital Bilateral Vocal Cord Paralysis and 13q Deletion (선천성 양측 성대마비와 13번 염색체 장완 결실이 동반된 비증후군성 간내담도부족증 1례)

  • Chung, Ju-Young;Lee, Jeong-Soo;Kim, Byung-Eoi;Choi, Myung-Jai;Park, Dong-Chul;Kim, Sang-Woo;Kang, Kyung-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.108-112
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    • 2001
  • Nonsyndromic intrahepatic bile duct paucity is known to be associated with several kinds of etiology such as infection, chromosomal anomaly, metabolic disease and idiopathic. We report a rare case of intrahepatic bile duct paucity with congenital bilateral vocal cord paralysis and 13q deletion.

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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 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
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    • v.20 no.2
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    • pp.118-125
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    • 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.

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Surgical Treatment of Traumatic Subglottic Stenosis; A Case Report (외상성 성문하 기관 협착증의 수술 치험 1례)

  • 최필조
    • Journal of Chest Surgery
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    • v.26 no.5
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    • pp.409-412
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    • 1993
  • We report a case of subglottic stenosis by blunt neck trauma. Preoperative CT showed a stenosis extending distally from just below the vocal cords for 4cm. Concomittent bilateral vocal cords paralysis and quadriplegia were present. At operation the lesion was severely adhesed and the lumen was nearly obstructed. The recurrent laryngeal nerves were embedded in fibrous tissue and were not identified at ease. The stenosed segment was resected and direct end-to-end anastomosis with preservation of the recurrent laryngeal nerves was performed. Six months latar he discharged with intermediate position of vocal cord paralysis.

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