• Title/Summary/Keyword: Vocal Cord Dysfunction

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A Case of Vocal Cord Dysfunction Masqueraded as Exercised-Induced Asthma (운동유발성 기관지천식으로 오인된 성대 기능 이상 1례)

  • Jo, Chang-Lae;Sym, Sun-Jin;Park, Sang-Hyun;Nam, Soon-Yuhl;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.265-270
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    • 2002
  • Vocal cord dysfunction (VCD) is respiratory disorder characterized by paradoxical closure of the vocal cord during the respiratory cycle leading to obstructive airway symptoms. The clinical presentation of VCD is often dramatic and its misdiagnosis as asthma or exercise-induced brochospasm(EIB) has led to inappropriate treatment including high dose corticosteroids, intubation, and tracheostomy. Many VCD patients are asymptomatic at rest and require exercise challenge to elicit symptoms and vocal cord abnormalities. The "gold standard" for the diagnosis of VCD remains laryngoscopy or bronchoscopy with direct visualization of paradoxical adduction of the vocal cords. We report a case of exercise-induced Vocal cord masqueraded as exercise-induced asthma unresponsive to corticosteroids. And bronchodilator confirmed by typical bronchoscopic findings with paradoxial adduction of the vocal cords.

A Case of Functional Upper Airway Obstruction Due to Vocal Cord Dysfunction in Obstructive Pulmonary Disease (폐쇄성 폐질환에 동반된 성대 운동이상에 의한 기능성 상기도폐색 1예)

  • Oh, Myoung;Kim, Sang-Cheol;Baik, Jae-Joong;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.270-274
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    • 2001
  • A functional upper airway obstruction due to a vocal cord dysfunction(VCD) is characterized by a paradoxical adduction of the vocal cords throughout the respiratory cycle with no obvious organic cause for the obstruction. It commonly occurs paroxysmally and imitates acute asthmatic attacks, often in patients with coexisting asthma. They present with episodes of dyspnea associated with inspiratory wheezing that persists despite conventional asthma treatment and a flattening of the inspiratory limb of the flow-volume curve ; an adduction of the vocal cord during inspiration. Failure to recognize concurrent vocal cord dysfunction and asthma has led not only to the excessive use of bronchodilators and corticosteroids, but also to intubation and tracheostomy. Here, we report a case of coexistent obstructive pulmonary disease and functional upper airway obstruction due to a vocal cord dysfunction where a bronchoscopy showed a paradoxical vocal cord motion and typical features of a variable extrathoracic obstruction and a lower airway obstruction on the Flow-volume loop during a symptomatic period.

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A Case of Functional Upper Airway Obstruction Due To Vocal Cord Dysfunction (성대 운동이상에 의한 기능성 상기도 폐색 1예)

  • Suh, Jung-Kyung;Lee, Sang-Yeub;Lee, Sang-Hwa;Park, Sang-Myun;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.449-454
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    • 1996
  • Functional upper airway obstruction due to vocal cord dysfunction is being increasingly recognized and has been variously described as "Munchausen's stridor", "Emotional laryngeal wheezing", "Nervous asthma". It's features are symptoms of acute reversible recurrent dyspnea associated with an inspiratory stridor, normal anatomy of the upper airway, demonstration of variable severe exthrathoracic upper airways obstruction with pathologic adduction of the vocal cord at bronchoscopy. The patients with this condition are frequently misdiagnosed as asthma and the diagnosis is often delayed. So they can present a serious medical problem and are exposed to the complication of treatment and investigation. We report a case of functional upper airway obstruction due to vocal cord dysfunction who showed paradoxical vocal cord motion at bronchoscopy and typical features of variable exthrathoracic obstruction on Flow-volume loop during a symptomatic period.

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Safety and Prognostic Impact of Prophylactic Level VII Lymph Node Dissection for Papillary Thyroid Carcinoma

  • Fayek, Ihab Samy;Kamel, Ahmed Ahmed;Sidhom, Nevine FH
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8425-8430
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    • 2016
  • Purpose: To study the safety of prophylactic level VII nodal dissection regarding hypoparathyroidism (temporary and permanent) and vocal cord dysfunction (temporary and permanent) and its impact on disease free survival. Materials and Methods: This prospective study concerned 63 patients with papillary thyroid carcinoma with N0 neck node involvement (clinically and radiologically) in the period from December 2009 to May 2013. All patients underwent total thyroidectomy and prophylactic central neck dissection including levels VI and VII lymph nodes in group A (31 patients) and level VI only in group B (32 patients). The thyroid gland, level VI and level VII lymph nodes were each examined histopathologically separately for tumor size, multicentricity, bilaterality, extrathyroidal extension, number of dissected LNs and metastatic LNs. Follow-up of both groups, regarding hypoparathyroidism, vocal cord dysfunction and DFS, ranged from 6-61 months. Results: The mean age was 34.8 and 34.3, female predominance in both groups with F: M 24:7 and 27:5 in groups A and B, respectively. Mean tumor size was 12.6 and 14.7mm. No statistical differences were found between both groups regarding age, sex, bilaterality, multicentricity or extrathyroidal extension. The mean no. of dissected level VI LNs was 5.06 and 4.72 and mean no. of metastatic level VI was 1 and 0.84 in groups A and B, respectively. The mean no. of dissected level VII LNs was 2.16 and mean no. of metastatic LNs was 0.48. Postoperatively temporary hypoparathyroidism was detected in 10 and 7 patients and permanent hypoparathyroidism in 2 and 3 patients; temporary vocal cord dysfunction was detected in 4 patients and one patient, and permanent vocal cord dysfunction in one and 2 patients in groups A and B, respectively. No significant statistical differences were noted between the 2 groups regarding hypoparathyroidism (P=0.535) or vocal cord dysfunction (P=0.956). The number of dissected LNs at level VI only significantly affected the occurrence of hypoparathyroidism (<0.001) and vocal cord dysfunction (<0.001).The DFS was significantly affected by bilaterality, multicentricity and extrathyroidal extension. Conclusions: Level VII nodal dissection is a safe procedure complementary to level VI nodal dissection with prophylactic central neck dissection for papillary thyroid carcinoma.

Maximal Inspiratory Pressure, Maximal Expiratory Pressure, and Maximum Phonation Time in Singers, Untrained Normal Person, and Patients with Vocal Cord Diseases (성악가와 성악훈련을 받지 않은 일반인과 성대질환이 있는 환자에서 최대흡기압, 최대호기압, 최대발성지속시간에 관한 연구)

  • 남도현;안철민;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.117-123
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    • 2002
  • MIP was significantly increased in singers, compared to the untrained group. MIP in patients showed decreasing tendency compared to the untrained group, but were significantly lower than that in singers. MEP in singers was higher than that in the untrained group. MPT increased significantly in singers, but diminished in patients compared to the untrained group. MIP, MEP, and MPT in male singers were 50.8%, 61.0%, and 28.7 % higher than those in female singers. MIP, MEP, and MPT in the untrained male were more increased 32.3%, 25.0%, and 28.7%, respectively than those in the untrained female. There was no correlation between MPT and MIP or MEP. Regression analysis of the data set showed that weight and vocal cord dysfunction was a positive predictor of MPT. Factors affecting MIP were male, singers and weight. Factors affecting MEP were male, singers, vocal cord dysfunction and weight.

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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 Vocal Cord Abscess after Injection Laryngoplasty (성대주입술 후 발생한 성대 내 농양 1례)

  • Yi, Jong-Sook;Kim, Ji-Won;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.2
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    • pp.142-144
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    • 2010
  • Unilateral vocal cord paralysis occurs from a dysfunction of the recurrent laryngeal nerve. It causes a characteristic hoarseness, shortness of breath and swallowing disability. Prompt injection laryngoplasty is a treatment options that aims to improve these symptoms less invasively and easily than any other procedures. Cross-linked hyaluronic acid (HA) is widely used injection material. It is non-mammalian polysaccharides derived from streptococcus strain and well known for its duration in vocal cord about 3-6 months after injection. However, there were no complication reports such as infection or rejection after HA injection laryngoplasty in previous report. We present a case of patient with laryngeal abscess after transcricothyroid membrane percutaneous HA injection laryngoplasty.

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Vocal Fold Paresis: Controversies and Consensus (불완전 성대 마비: 논란과 합의)

  • Kim, Tae-Wook;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.1
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    • pp.27-31
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    • 2010
  • Mild vocal fold hypomobility is a common finding of which clinical significance is incompletely understood. Recently, electrophysiologic investigations have shown that vocal fold hypomobility is a continuum of neurogenic dysfunction ; partial denervation (paresis), complete denervation (paralysis), and variable degrees and patterns of reinnervation. Despite a sound pathophysiological basis for its existence, interest in and acceptance of the diagnosis of vocal fold paresis is relatively recent. Vocal fold paresis may be a relatively common and often overlooked condition that can be difficult to diagnose since laryngoscopy does not reliably distinguish innocent laryngeal asymmetry from hypomobility caused by paresis. Although not entirely free from error, laryngeal electromyography seems to hold more promise as a means of reliable diagnosis than laryngoscopy, and should be employed systematically in the evaluation of suspected paresis. The means to help most patients with paresis already exists in the repertoire of interventions developed to treat paralysis. However, since the vocal fold retains substantial movement, more conservative treatment strategy is recommended as a first line of treatment. The authors reviewed the representative reports of vocal fold paresis and summarized the controversies and consensus regarding the vocal fold paresis.

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State of the Art for Refractory Cough: Multidisciplinary Approach

  • Anne E. Vertigan
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.4
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    • pp.264-271
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    • 2023
  • Chronic cough is a common problem that can be refractory to medical treatment. Nonpharmaceutical management of chronic cough has an important role in well selected patients. This review article outlines the history of chronic cough management, current approaches to speech pathology management of the condition and new modalities of nonpharmaceutical treatment. There is a need for further research into nonpharmaceutical options with well described randomised control trials.