Cases reported "Vocal Cord Paralysis"

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1/392. Sudden recurrent laryngeal nerve paralysis due to apoplexy of parathyroid adenoma.

    Neoplastic lesions of the parathyroid are rare, and most of these are adenomas. Even rarer is a secondary involvement of the recurrent laryngeal nerve. A case is presented of sudden onset hoarseness in a 64-year-old man caused by acute vocal cord paralysis due to bleeding within an adenoma of the lower right parathyroid gland. Acute onset of vocal cord paralysis is rarely associated with benign processes; the current case is only the second report associated with parathyroid adenoma.
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keywords = vocal
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2/392. General anaesthesia for thyroplasty.

    A new anaesthetic technique is described for thyroplasty. Thyroplasty was performed to restore the voice in unilateral vocal cord paralysis. After skin incision and dissection down to the larynx, a window was cut in the thyroid ala and a silastic wedge used to displace the vocal cord medially. The required size of this wedge was determined by pre-operative computerized tomography scanning of the larynx. At this point the patient had to be awake and cooperative to allow repeated phonation to facilitate correct displacement of the vocal cord.
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ranking = 1.5
keywords = vocal
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3/392. vocal cord paralysis and hypoventilation in a patient with suspected leigh disease.

    The authors report the case of a 16-month-old male with suspected leigh disease, which was diagnosed on the basis of the clinical manifestations, abnormal lactate stimulation test, proton magnetic resonance spectroscopy, and neuroradiologic findings. Progressive stridor resulting from bilateral vocal cord paralysis and hypoventilation was evident. The authors suggest that for infants or children who exhibit vocal cord paralysis, mitochondrial disorders, such as leigh disease, should be considered.
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ranking = 1
keywords = vocal
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4/392. recurrent laryngeal nerve injury caused by a laryngeal mask airway.

    Although there have been few reports of serious complications with the laryngeal mask airway, we record a case of permanent unilateral vocal cord paralysis following the use of a laryngeal mask airway and review the literature describing injuries, not only to the recurrent laryngeal nerves but also to the hypoglossal and lingual nerves.
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ranking = 0.5
keywords = vocal
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5/392. Thyroplasty under general anesthesia using a laryngeal mask airway and fibreoptic bronchoscope.

    PURPOSE: To report the management of a patient, with unilateral vocal cord paralysis, undergoing thyroplasty, under general anesthesia. CLINICAL FEATURES: A 25-yr-old man developed hoarseness and occasional episodes of pulmonary aspiration, caused by unilateral vocal cord paralysis. He was scheduled for thyroplasty, in an attempt to ease phonation and to decrease or prevent further episodes of pulmonary aspiration. He refused local anesthesia with sedation and it was therefore decided to attempt the procedure under general anesthesia. The paralysed vocal cord was displaced inwards by a wedge inserted through a window in the thyroid cartilage. We assessed the ideal position of the wedge by using a fibreoptic bronchoscope and laryngeal mask airway during general anesthesia, instead of phonation. CONCLUSION: We describe the successful use of a general anesthetic for a thyroplasty, a procedure normally done under local anesthesia with or without sedation, in a patient who was keen to have surgery, but who refused local anesthesia with sedation.
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ranking = 1.5
keywords = vocal
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6/392. Left vocal cord paralysis as a primary manifestation of invasive pulmonary aspergillosis in a nonimmunocompromised host.

    We report the first case (to our knowledge) of vocal cord paralysis as a primary manifestation of invasive pulmonary aspergillosis, which occurred in a 69-year-old woman without immunodeficiency. Her chest radiograph showed left upper lobe infiltration with pleural thickening, and a computed tomogram of her chest showed a thick pleural reaction and fibrosis around the arch of the aorta. A transbronchial biopsy specimen revealed aspergillus infection. The patient was treated with oral itraconazole. However, since vocal cord paralysis persisted, the patient underwent type I thyroplasty to improve vocal function. A review of the literature showed that the incidence of invasive pulmonary aspergillosis has increased, even in nonimmunocompromised subjects, and that the disease has a potential for recurrent laryngeal nerve palsy. Therefore, invasive pulmonary aspergillosis should be considered in patients with vocal cord paralysis.
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ranking = 4
keywords = vocal
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7/392. Idiopathic bilateral vocal fold weakness.

    OBJECTIVE: To describe an unrecognized clinical entity, idiopathic bilateral vocal fold weakness, and propose recommendations regarding the diagnosis and management of these cases. STUDY DESIGN: Retrospective, nonrandomized case study. methods: All cases of bilateral vocal fold weakness evaluated at the University of washington voice disorders Clinic between 1991 to 1998 were reviewed. RESULTS: Four patients with bilateral laryngeal weakness were determined to have idiopathic bilateral vocal fold paresis following exhaustive workups, including videostroboscopy, bilateral laryngeal electromyography (EMG), neurological consultation, and other pertinent studies. CONCLUSIONS: Performing bilateral laryngeal EMG is an essential aspect of the workup of any laryngeal weakness case, particularly if the etiology is unknown on presentation. Idiopathic bilateral vocal fold weakness is an underrecognized but real clinical diagnosis that will become more familiar with the increasing utilization of laryngeal EMG in clinical situations.
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ranking = 4
keywords = vocal
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8/392. Neuralgic amyotrophy presenting with bilateral vocal cord paralysis in a child: a case report.

    Acute stridor and bilateral vocal cord paralysis is not uncommon in the neonate but is unusual in the older child. We report the first case of bilateral vocal cord paralysis secondary to neuralgic amyotrophy, a peripheral polyneuropathy, in a 5-year-old child. An extensive workup revealed a paralyzed right hemidiaphragm, arm weakness and an EMG pattern consistent with neuralgic amyotrophy. Neuralgic amyotrophy is an uncommon disorder in pediatric patients which may involve cranial and peripheral nerves including the phrenic nerves and rarely the recurrent laryngeal nerves. We propose that the diagnosis be considered in children who present with bilateral vocal cord paralysis and other associated neurologic findings.
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ranking = 3.5
keywords = vocal
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9/392. Invasion of the recurrent laryngeal nerve by adenoid cystic carcinoma. An unusual cause of true vocal fold paralysis.

    True vocal fold paralysis and goitre are both common problems encountered in ENT practice. Their co-existence, however, should arouse suspicion of the presence of malignant thyroid disease. A rare case of true vocal fold paralysis caused by a clinically occult subglottic adenoid cystic carcinoma, in a 72-year-old, is described. The existence of multinodular goitre in this patient was co-incidental and confounded the diagnostic process.
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ranking = 3
keywords = vocal
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10/392. Botulinum toxin injection in the treatment of vocal fold paralysis associated with multiple sclerosis: a case report.

    Botulinum toxin has been demonstrated clinically to be an effective treatment for a variety of laryngeal problems, most notably spasmodic dysphonia. As in other movement disorders, the theory behind the injection of this substance in the larynx has been a weakening of the vocal fold musculature to relieve uncoordinated and spasmodic movement of the vocal folds, presumably rebalancing the forces within the intralaryngeal musculature. Recently, this concept was applied to help reposition the arytenoid cartilage in acute and longstanding anteromedial cricoarytenoid dislocations. This same concept may apply to the paralyzed vocal fold. In support of this idea, a number of investigators have shown that immobile, clinically paralyzed vocal folds may still have partial voluntary motor unit activity. This voluntary activation may not produce clinically evident movement but may be sufficient to produce tone within the fold. If the voluntary motor units in the abductor musculature of the paralyzed fold are weakened with botulinum toxin, the continued pull of the functioning adductor musculature may be sufficient to medialize the paralyzed fold. This idea has been supported by animal experiments, which have shown that botulinum toxin may affect the ability of the fold to rebalance itself. With this evidence in mind, a patient with fold immobility secondary to multiple sclerosis was treated in an attempt at laryngeal rebalancing, using botulinum toxin to medialize the fold. However, instead of simply having the fold return fixed to the midline, the patient regained normal laryngeal mobility and voice. While it is unclear whether the botulinum toxin alone was responsible, the coincidence of this occurrence certainly requires reporting. This paper is a report of the first successful treatment of vocal fold paralysis using botulinum toxin to treat vocal fold fixation in a patient with multiple sclerosis.
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ranking = 5.0000011090013
keywords = vocal, motor
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