Vocal fold paresis

Md, Mausumi N Syamal; Benninger, Michael S.

doi:10.1097/moo.0000000000000259

Cited by 19 publications

(9 citation statements)

References 49 publications

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“…These abnormalities are associated with breathing difficulty, dysphonia, and vocal fatigue. Also, neurogenic VCI can occur secondary to systemic disease, malignancy, and surgical interventions around the neck and thorax [ 2 ]. The surgery including thyroidectomy, esophagectomy, and lung resection can result in RLN injury due to anatomical course of RLN [ 23 24 25 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…A total of 137 patients, who underwent LEMG due to clinical symptoms of VCI or abnormal findings in laryngoscopy, were enrolled from January 2011 to December 2016. Motion abnormalities including vocal cord hypomobility or glottic insufficiency were considered as abnormal findings in the laryngoscopy [ 2 ]. All the patients who complained symptoms of dysphagia or were suspected to be at risk of aspiration carried out a videofluoroscopic swallowing study (VFSS).…”

Section: Methodsmentioning

confidence: 99%

“…Vocal cord immobility (VCI) is defined as various spectrum of motion impairment in the vocal cord. Although hoarseness is the main symptom in VCI, dysphonia, odynophonia, dysphagia, chronic cough, and laryngospasm can also occur [ 1 2 ]. Visual inspection by a laryngoscopy and electrophysiologic study, such as laryngeal electromyography (LEMG) can help to differentiate the neurogenic and non-neurogenic causes of VCI [ 3 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Viral or bacterial infections can attribute to post-infectious neuropathies [ 15 16 ] and a wide spectrum of malignancies or tumors present as a paralysis. Also, VCI can be seen in systematic neurologic diseases such as myasthenia gravis, Charcot-Marie-Tooth disease, and multiple sclerosis [ 2 ]. With LEMG results, it aids to select other diagnostic tests and determine timing and type of treatments.…”

Section: Introductionmentioning

confidence: 99%

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

2017

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ObjectiveTo analyze the clinical characteristics between neurogenic and non-neurogenic cause of vocal cord immobility (VCI).MethodsThe 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.ResultsAmong 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).ConclusionIn 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.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

2017

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“…Congenital causes of vocal fold paralysis include tracheoesophageal fistula, vascular ring, dysmorphic syndromes (Mobius, Goldenhaar), syndromes involving brainstem dysfunction, and neuromuscular disorders such as Charcot–Marie–Tooth [9]. The paralysis caused by inborn anomalies of the RLN has not previously been reported.…”

Section: Discussionmentioning

confidence: 99%

A novel variation of the recurrent laryngeal nerve

Wang

2017

BMC Surg

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BackgroundInjury to the recurrent laryngeal nerve is one of the most severe complications of thyroid surgery. Several anatomic variations of the nerve increase the likelihood of iatrogenic damage.Case presentationA 50-year-old woman was presented to our department with a nodule in the right thyroid lobe, and she reported no voice changes. She had no history of surgery or radiation to the head or neck. Fine-needle aspiration was recorded as papillary thyroid carcinoma. The preoperative laryngoscopy revealed left vocal cord paralysis. Right thyroid lobectomy was performed. A scarce course of the left recurrent laryngeal nerve was found during the operation that ascended along the medial edge of the superior thyroid pole and finally disappeared beneath the superior cornu of the thyroid cartilage without any tracheal, esophageal, or laryngeal branches. The patient was discharged on the third postoperative day with the diagnoses of papillary thyroid carcinoma and congenital left vocal cord paralysis.ConclusionsThe novel variation of the recurrent laryngeal nerve may challenge the current concept of the anatomy of the nerve. The vocal folds mobility should be examined routinely before surgery in patients undergoing thyroid operation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12893-017-0263-5) contains supplementary material, which is available to authorized users.

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Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment

et al. 2020

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Background: Laryngeal dysfunction after thyroid and parathyroid surgery requires early recognition and a standardized approach for patients that present with voice, swallowing, and breathing issues. The Endocrine Committee of the American Head and Neck Society (AHNS) convened a panel to define the terms "immediate vocal fold paralysis" and "partial neural dysfunction" and to provide clinical consensus statements based on review of the literature, integrated with expert opinion of the group. Methods: A multidisciplinary expert panel constructed the manuscript and recommendations for laryngeal dysfunction after thyroid and parathyroid surgery. A meta-analysis was performed using the literature and published guidelines. Consensus was achieved using polling and a modified Delphi approach. Results: Twenty-two panelists achieved consensus on five statements regarding the role of early identification and standardization of evaluation for patients with "immediate vocal fold paralysis" and "partial neural dysfunction" after thyroid and parathyroid surgery. Conclusion: After endorsement by the AHNS Endocrine Section and Quality of Care Committee, it received final approval from the AHNS Council.

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Vocal fold paresis

Abstract: Patients with paresis often present with symptoms of a hyperkinetic voice disorder. Regardless of the myriad of causes, their assessment hinges upon close clinical evaluation with videostroboscopy aided with LEMG.

Cited by 19 publications

References 49 publications

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

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

A novel variation of the recurrent laryngeal nerve

Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment

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