Vocal fold paralysis in the presence of thyroid disease: management strategies

2013 ◽  
Vol 127 (8) ◽  
pp. 768-772 ◽  
Author(s):  
F O'Duffy ◽  
C Timon
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Disease ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Benign Thyroid Disease ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Benign Thyroid

AbstractBackground:The presentation of vocal fold palsy with associated goitre has historically been considered to be due to malignancy with recurrent laryngeal nerve involvement.Method:In total, 830 consecutive patients who underwent thyroid surgery were reviewed. Patients with vocal fold paralysis and thyroid disease were examined to determine the aetiology of the paralysis.Results:Nine patients were identified with new onset vocal fold paralysis prior to thyroid surgery. Six of the patients with recurrent laryngeal nerve paralysis had benign thyroid disease, and for three of the patients the paralysis was secondary to malignancy.Conclusion:Recurrent laryngeal nerve paralysis in the presence of thyroid disease is not pathognomonic for malignancy. The current literature may underestimate the association between vocal fold paralysis and benign thyroid disease. The paper also highlights the importance of recurrent laryngeal nerve preservation in patients who present with palsy and thyroid disease; the relief of benign compression often leads to complete recovery of recurrent laryngeal nerve paralysis.

Recurrent laryngeal nerve palsy secondary to benign thyroid disease

1994 ◽  
Vol 108 (10) ◽  
pp. 878-880 ◽  
Author(s):  
J. E. Fenton ◽  
C. I. Timon ◽  
D. P. McShane
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Disease ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Recurrent Nerve ◽  
Benign Thyroid Disease ◽  
Nerve Paralysis ◽  
Benign Thyroid

Abstract: A recurrent nerve palsy occurring in the presence of a goitre is considered to be caused by thyroid malignancy until proven otherwise.Three cases are described in which benign thyroid disease resulted in recurrent laryngeal nerve paralysis. Recent haemorrhage was implicated histologically as the possible aetiology in all three cases. The importance of identifying and preserving the recurrent laryngeal nerve in the surgical management is highlighted.

Acute bilateral vocal fold paresis as a symptom of benign thyroid disease

1994 ◽  
Vol 108 (5) ◽  
pp. 433-434 ◽  
Author(s):  
Tomasz Kręcicki ◽  
Tadeusz Łukiénczuk ◽  
Maria Zalesska-Kręcicka ◽  
Waldemar Balcerzak
Keyword(s):  
Thyroid Disease ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
Benign Thyroid Disease ◽  
Review Of The Literature ◽  
Nerve Paralysis ◽  
Vocal Fold Paresis ◽  
Laryngeal Nerve Paralysis ◽  
Benign Thyroid

AbstractA case of bilateral laryngeal nerve paralysis caused by a small goitre is reported. After thyroidectomy the return of vocal fold movements was observed. A review of the literature is presented. The possibility of acute airway distress caused by a slightly enlarged goitre is emphasized.

Effect of Vocal Fold Augmentation on Laryngeal Vibration in Simulated Recurrent Laryngeal Nerve Paralysis: A Study of Teflon and Phonogel

1989 ◽  
Vol 98 (3) ◽  
pp. 220-227 ◽  
Author(s):  
Terrence K. Trapp ◽  
Gerald S. Berke ◽  
David G. Hanson ◽  
Theodore S. Bell ◽  
Paul H. Ward
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Acoustic Analysis ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Paralysis ◽  
Advantages And Disadvantages ◽  
Laryngeal Nerve Paralysis ◽  
Bovine Collagen ◽  
Vocal Fold Augmentation

Flaccid laryngeal nerve paralysis may be treated by vocal fold augmentation with Teflon injection, which is successful to various degrees depending on the subjective interpretation of the patient or clinician. A new material, Phonogel, consisting of cross-linked bovine collagen, is available but not approved for human use in this area. Ten dogs were submitted to videostroboscopy, photoglottography, electroglottography, and acoustic analysis in the normal state, with simulated recurrent laryngeal nerve paralysis, and with injection of either Teflon or Phonogel. A statistical comparison and the advantages and disadvantages of each material are discussed in relation to this study and its clinical use.

Coordinated Electrical Pacing of Vocal Cord Abductors in Recurrent Laryngeal Nerve Paralysis

1985 ◽  
Vol 93 (5) ◽  
pp. 634-638 ◽  
Author(s):  
Randal A. Otto ◽  
Jerry Templer ◽  
William Davis ◽  
David Homeyer ◽  
Mark Stroble
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Electromyographic Activity ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Alternative Approach ◽  
Posterior Cricoarytenoid ◽  
Electrical Pacing

Electrodes were placed into the posterior cricoarytenoid and diaphragmatic muscles of five tracheostomized dogs. With the use of a sensor that would selectively detect diaphragmatic electromyographic activity, this activity served as a trigger and was amplified and interfaced with a muscle stimulator attached to electrodes placed in the posterior cricoarytenoid muscles. In all animals obvious physiologic synchrony of vocal fold abduction and a reduction of the negative inspiratory intratracheal pressure were observed during electrical pacing. This represents a preliminary step in the development of an alternative approach to the patient with bilateral recurrent laryngeal nerve paralysis.

scholarly journals Partial Recurrent Laryngeal Nerve Paralysis or Paresis? In Search for the Accurate Diagnosis

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Alexander Delides ◽  
Panagiotis Kokotis ◽  
Pavlos Maragoudakis
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
Accurate Diagnosis ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Laryngeal Electromyography ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Partial Paralysis

“Partial paralysis” of the larynx is a term often used to describe a hypomobile vocal fold as is the term “paresis.” We present a case of a dysphonic patient with a mobility disorder of the vocal fold, for whom idiopathic “partial paralysis” was the diagnosis made after laryngeal electromyography, and discuss a proposition for a different implementation of the term.

Intracordal Injection Increases Glottic Closing Force in Recurrent Laryngeal Nerve Paralysis

1992 ◽  
Vol 107 (3) ◽  
pp. 451-456 ◽  
Author(s):  
Yasunari Iwanaga ◽  
Tadatsugu Maeyama ◽  
Toshiro Umezaki ◽  
Takemoto Shin
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Peak Pressure ◽  
Laryngeal Nerve ◽  
Control Group ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Lesion ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Closing Force

Glottic closing pressure during swallowing was measured in the cat with a catheter pressure transducer to study the effectiveness of intracordal injection in increasing glottic pressure in unilateral recurrent laryngeal nerve paralysis. Swallows were elicited by pouring water into the pharynx while the animal was under light anesthesia with ketamine. Peak pressure of the glottic closure for the control group during deglutition was 68.0 ± 10.5 mm Hg (mean ± standard deviation). Peak pressure decreased to 22.0 ± 3.6 mm Hg just after sectioning of the unilateral recurrent laryngeal nerve, and rose to 39.8 ± 8.3 mm Hg by silicon injection into the paralyzed vocal fold. In a study of chronic cases 1 month or more after unilateral recurrent laryngeal nerve section, peak pressure was 49.1 ± 23.4 mm Hg, and varied widely from 21 to 92 mm Hg because of differences in the position of the paralyzed vocal fold and the degree of compensation by the unaffected vocal fold. In the group that had the paralyzed vocal fold fixed in the median position, peak pressure was almost the same as that of the control group. When the paralyzed vocal fold was fixed in either the paramedian or lateral position, peak pressure was 33.3 ± 7.0 mm Hg. This value was significantly elevated to 45.8 ± 10.4 mm Hg by injection of silicon, though it remained lower than that of the control. These results suggest that the decrease in glottic closing force during swallowing as a result of unilateral recurrent laryngeal nerve lesion is compensated for by the unaffected vocal fold to some degree and is improved by intracordal injection.

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