• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.152-156
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• 2014

Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy.

• 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.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.400-404
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• 2022

A 3-year-old Thoroughbred gelding presented with left laryngeal hemiplegia with a history of laryngoplasty (tie-back surgery) failure. Postoperative endoscopy revealed no abduction or no inflammatory changes in the left arytenoid cartilage. The owner opted for the horse to undergo partial arytenoidectomy due to failed laryngoplasty. A tracheostomy tube was intubated through a mid-cervical tracheotomy to secure the airway under general anesthesia, and; laryngotomy was performed to access the arytenoid cartilage in dorsal recumbency. A partial arytenoidectomy was performed with endoscopic assistance through the left nostril, and the left arytenoid cartilage was removed, excluding the muscular process. Antibiotic and anti-inflammatory agents were administered postoperatively, and the incision site was cleaned using normal saline and antibiotic ointment twice daily. On the 12th postoperative day, endoscopy revealed redundant corniculate process mucosa at the surgical site, which was removed using rongeur forceps directly through the previous laryngotomy incision. The horse showed no significant complications during the hospitalization. Two months after surgery, the surgical site reportedly recovered with no evidence of granulation tissue. The horse returned to training and racing 3 and 7 months postoperatively, respectively. This is the first case report of a partial arytenoidectomy in a horse in South Korea. In this case, the horse returned to training after partial arytenoidectomy without significant complications, indicating that partial arytenoidectomy could be beneficial for failed laryngoplasty.