Laryngeal Paralysis in Children

1982 ◽  
Vol 91 (4) ◽  
pp. 417-424 ◽  
Author(s):  
Seymour R. Cohen ◽  
Kenneth A. Geller ◽  
Jeffrey W. Birns ◽  
Jerome W. Thompson
Keyword(s):  
Statistical Analysis ◽  
Vocal Cord ◽  
Conservative Therapy ◽  
Spontaneous Recovery ◽  
Vocal Cord Paralysis ◽  
Laryngeal Paralysis

The charts of 100 children with laryngeal paralysis were reviewed. The patients in this study had either unilateral or bilateral abductor vocal cord paralysis. The literature and pathophysiology are reviewed. A statistical analysis of each group of patients according to etiology is reported. The follow-up, progress and recovery are detailed. The need for observation and conservative therapy is reinforced by the tendency for spontaneous recovery. Suggestions regarding treatment are given.

Recovery of Vocal Cord Motion Among Pediatric Patients

2021 ◽  
pp. 000348942110333
Author(s):  
Courtney Ann Prestwood ◽  
Ashley B. Brown ◽  
Romaine F. Johnson
Keyword(s):  
Vocal Cord ◽  
Spontaneous Recovery ◽  
Vocal Cord Paralysis ◽  
Pediatric Population ◽  
Current Evidence ◽  
Symptom Improvement ◽  
Patient Counseling ◽  
Early Recovery ◽  
Kaplan Meier ◽  
Recovery Group

Objectives: Patients with vocal cord paralysis can experience feeding, respiratory, and vocal problems leading to disability and decreased quality of life. Current evidence suggests waiting a period of 12 months for spontaneous recovery before permanent interventions. This study aims to determine the time to recover spontaneously and vocal cord movement in a pediatric population and create a model for evidence-based patient counseling. Study Design: Retrospective longitudinal cohort study. Methods: The report is a single institution longitudinal study on vocal cord paralysis recovery. Patients were categorized based on spontaneous recovery with vocal cord movement or no recovery. Recovery rates were determined using the Kaplan-Meier method. Results: Of 158 cases of vocal cord paralysis over a 4-year period, 36 had spontaneous recovery with symptom improvement and motion return. The average recovery was 8.8 months for those who recovered, and 78% recovered within 9 months. Two groups emerged from the data: an early recovery group with spontaneous recovery before 12 months and a late recovery group after 12 months. Children with dysphonia and paralysis due to cardiac surgery were less likely to recover, and children with aspiration were more likely to recover. Children with gastrointestinal comorbidities were less likely to recover; however, those who did recover were more likely to have recovered after 12 months. Based on our model, there is about a 3% chance of recovery between 9 and 12 months. Conclusions: Patients should be counseled about earlier interventions. Waiting the conventional 12 months for only a 3% chance of spontaneous recovery without intervention or laryngeal EMG may not be the preferred option for some patients and their families.

The Effect of Vocal Cord Paralysis on the Cricoarytenoid Joint

1981 ◽  
Vol 89 (3) ◽  
pp. 419-422 ◽  
Author(s):  
Marc F. Colman ◽  
Ilsa Schwartz
Keyword(s):  
Pilot Study ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Limiting Factors ◽  
Laryngeal Paralysis ◽  
The Status ◽  
Cricoarytenoid Joint ◽  
Variable Success ◽  
Type Of Surgery

Vocal cord reinnervation using neuromuscular pedicle techniques have met with variable success. One of the limiting factors in this type of surgery is the status of the cricoarytenoid joint. In this pilot study we studied the effect of immobilization secondary to deinnervation in the rat. There were no significant joint changes in the animals operated on after periods of up to 11 months. This agrees well with reported successes of reinnervation procedure 20 years after laryngeal paralysis.

PS01.138: EXPERIENCE FROM 102 PATIENTS WITH CONTINUOUS INTRAOPERATIVE VAGUS NERVE STIMULATION DURING MINIMALLY INVASIVE ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 89-89
Author(s):  
Ian Yu Hong Wong ◽  
Raymond King Yin Tsang ◽  
Desmond Kwan Kit Chan ◽  
Claudia Lai Yin Wong ◽  
Tsz Ting Law ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Vocal Cord ◽  
Nerve Stimulation ◽  
Vocal Cord Paralysis ◽  
Minimally Invasive Esophagectomy ◽  
Intraoperative Complications ◽  
Early Recovery ◽  
Invasive Esophagectomy ◽  
Assessment And Treatment

Abstract Background The incidence of recurrent laryngeal nerve (RLN) injury after esophagectomy can be as high as 60–70% especially when lymphadenectomy is performed along bilateral RLN. Vocal cord paralysis is associated with increased pulmonary complication rate, longer hospital stay, and impaired quality-of-life. The authors have modified the Continuous Intraoperative Nerve Monitoring (CIONM) method for minimally invasive esophagectomy. This study reviews our experience in the first 102 patients. Methods From May 2014 to January 2018, patients who underwent thoracoscopic esophagectomy were recruited. CIONM and intermittent nerve stimulation were routinely used during left RLN lymphadenectomy. For right RLN dissection, only intermittent nerve stimulation was used because of much lower chance of nerve injury. Routine direct laryngoscopy was performed on postoperative day one to assess the vocal cord status. Patients with RLN palsy are referred to otorhinolaryngologist for assessment and treatment. Surgical outcome, especially RLN palsy and recovery rates were documented. Results 102 patients were recruited and 73 patients had more than one year follow up. Twenty-two patients had RLN palsy (21.6%); right side in 3, left side in 18, and bilateral in one. Thirty-eight patients (37%) had only unilateral or no RLN dissection performed. This was because of R2 resection negating the benefits of RLN dissection (15.6%), poor pulmonary exposure (9.8%), other technical difficulties (7.8%), preoperative vocal cord palsy (2%), intraoperative complications (1%) and uncertain contralateral nerve integrity (1%). For those 90 patients with successful CIONM, 20 RLN palsy (22.2%), 10 of whom underwent injection thyroplasty within 2–80 days. Thyroplasty was not performed in 12 patients as they had good compensation from the contralateral cord (58.3%), early recovery within 2 weeks (16.7%) tracheostomized status (16.7%) or refusal (8.3%). Thirteen patients (59%) recovered within 2–72 weeks (Median 6 weeks). For the 73 patients with more than 1 year follow up, only 4 has residual vocal cord paralysis, making a genuine cord palsy rate of 5.5%. Conclusion Lymphadenectomy along bilateral RLN is technically demanding. CIONM is a sensitive tool to guide surgeons for safer dissection. Proper patient selection, postoperative assessment and treatment protocol can reduce the morbidity of RLN injury. Majority of the vocal cord paralysis is temporary Disclosure All authors have declared no conflicts of interest.

Statistical Analysis of Malignant Tumors Detected as the Cause of Vocal Cord Paralysis

ORL ◽  
1994 ◽  
Vol 56 (3) ◽  
pp. 161-165 ◽  
Author(s):  
Masaki Furukawa ◽  
Madoka Kaneko Furukawa ◽  
Kiminao Ooishi
Keyword(s):  
Statistical Analysis ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Malignant Tumors

Laryngeal Paralysis Teflon® Injection

1979 ◽  
Vol 88 (5) ◽  
pp. 647-657 ◽  
Author(s):  
William W. Montgomery
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Postoperative Management ◽  
Review Of The Literature ◽  
Laryngeal Paralysis

This report is a review of the literature combined with the author's experience concerning Teflon injection of the larynx. Included are the etiology and diagnosis of vocal cord paralysis, indications and contraindications for Teflon injection of the larynx, its histopathology, pre- and postoperative management, proper and improper techniques for injecting Teflon, complications, and reasons for failure.

scholarly journals Impact of COVID-19 on vocal cord mobility: a case series study

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Sameh M. Zamzam ◽  
Rania Gamal Hanafy
Keyword(s):  
Viral Infection ◽  
Vocal Cord ◽  
Spontaneous Recovery ◽  
Vocal Cord Paralysis ◽  
Case Series ◽  
World Health ◽  
Clinical Scenarios ◽  
Case Series Study ◽  
The World ◽  
Series Study

Abstract Background The World Health Organization (WHO) has declared the pandemic of COVID-19 infection in March 2020, most of cases presented with mild symptoms, and a significant number of cases showed variable neurological pictures. Vocal cord paralysis with no clear cause is termed as idiopathic vocal cord paralysis and supposed to be caused by viral infection. This is a case series study; data were collected prospectively from patients presented to the ENT clinic of Kasr Alainy (Cairo university) and Railway hospitals. Patients presented with defective vocal cord movement with concurrently or recently passed COVID-19 infection were reported from March 2020 to April 2021. Results Authors have reported 6 cases of vocal cord paralysis mainly unilateral due to COVID-19 infection as an only clear cause within 14 months. Age ranges from 39 to 69 years, 2 males and 4 females. Patients presented with different clinical scenarios. Follow-up of the cases showed spontaneous recovery in 5 cases and one case underwent cord medialization. Conclusion Viral infection could be an underlying cause of idiopathic laryngeal cord paralysis; in the new era of the COVID-19 pandemic, physicians all over the world noticed variable neurological pictures; in this study, we presented 6 cases of vocal cord paralysis mainly unilateral supposed to be due to COVID-19 infection; all cases showed spontaneous recovery apart from one case that needed medialization of the cord.

Bilateral Congenital Vocal Cord Paralysis: A 16-Year Institutional Review

2005 ◽  
Vol 133 (2) ◽  
pp. 241-245 ◽  
Author(s):  
R. Christopher Miyamoto ◽  
Sanjay R. Parikh ◽  
Walid Gellad ◽  
Greg R. Licameli
Keyword(s):  
Vocal Cord ◽  
Spontaneous Recovery ◽  
Vocal Cord Paralysis ◽  
Recovery Of Function ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Bilateral Vocal Cord Paralysis ◽  
True Vocal Cord ◽  
Arnold Chiari Malformation ◽  
Institutional Review

Objective: To review the management and outcome of bilateral congenital true vocal cord paralysis in 22 patients treated over a 16-year period and to review the role of tracheostomy in these patients. Design: Retrospective chart review. Setting: Pediatric tertiary hospital. Patients: Twenty-two pediatric patients diagnosed with bilateral congenital true vocal cord paralysis. Interventions: Flexible or rigid diagnostic evaluation, tracheostomy, and vocal cord lateralization procedures. Main Outcomes Measures: Vocal cord recovery and decannulation. Results: With a mean follow up of 50 months, 15 of 22 patients (68%) with bilateral vocal cord paralysis required tracheostomy for airway securement. Of the 15 tracheotomized patients, 10 were successfully decannulated (8 had spontaneous recovery, whereas 2 required lateralization procedures). Eleven of these patients with tracheostomy had comorbid factors, including neurologic abnormalities (midbrain/brainstem dysgenesis, Arnold-Chiari malformation, global hypotonia, and developmental delay). Of the 7 patients not requiring tracheostomy, 6 recovered vocal cord function (86%). Conclusion: In our series of 22 patients with bilateral vocal cord paralysis, 14 had spontaneous recovery of function. Patients managed with tracheostomy were noted to have a high incidence of comorbid factors. In this series, recovery rates were found to be higher in nontracheostomized patients than in tracheostomized patients. Patients can be carefully selected for observation versus tracheostomy at the time of diagnosis based on underlying medical conditions.

Vocal Cord Paralysis in Children 1 Year of Age and Younger

1986 ◽  
Vol 95 (6) ◽  
pp. 622-625 ◽  
Author(s):  
Richard D. Gentile ◽  
Robert H. Miller ◽  
Gayle E. Woodson
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Birth Trauma ◽  
Accurate Diagnosis ◽  
Male Predominance ◽  
Fiberoptic Laryngoscope

Twenty-two patients 1 year of age or younger were diagnosed as having unilateral or bilateral vocal cord paralyses between 1962 and 1985. There was a marked male predominance, and 12 of the paralyses were bilateral. Congenital neurological malformations were the cause in six patients, birth trauma in five, surgery in four, syphilis in one, and six cases were idiopathic. Tracheotomy was necessary in 11 of the patients with bilateral paralyses. Ten of the 16 patients for whom follow-up was available had resolution of the paralysis from 1 week to 5 years of age. The importance of making an accurate diagnosis is stressed, as is using the fiberoptic laryngoscope.

Laryngeal Electromyography Findings in Idiopathic Congenital Bilateral Vocal Cord Paralysis

1996 ◽  
Vol 105 (3) ◽  
pp. 207-212 ◽  
Author(s):  
Robert G. Berkowitz
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Prognostic Significance ◽  
Early Recovery ◽  
Bilateral Vocal Cord Paralysis ◽  
Abductor Paralysis ◽  
Significant Clinical Improvement ◽  
Posterior Cricoarytenoid ◽  
Laryngeal Emg

Children with idiopathic congenital bilateral vocal cord paralysis (BVCP) were investigated by electromyography (EMG) of the posterior cricoarytenoid and thyroarytenoid muscles to determine whether laryngeal EMG findings had diagnostic or prognostic significance. Four children between 3 weeks and 33 months of age were studied. Three had abductor paralysis and were tracheostomy-dependent, while the fourth had adductor paralysis requiring a feeding gastrostomy. Two of these patients also had other anomalies. Motor unit potentials showing phasic bursts with respiration were found in all four cases, while three children developed a full interference pattern on lightening of the anesthetic. Follow-up for between 37 and 52 months showed no significant clinical improvement in any of the patients. While the diagnosis of idiopathic congenital BVCP can represent a heterogeneous group of conditions, the findings suggest that normal laryngeal EMG findings may be a feature of idiopathic congenital BVCP but do not imply a favorable prognosis for early recovery. They may, however, have implications to explain the likely site of lesion in idiopathic congenital BVCP.

scholarly journals Stereotactic radiosurgery in patients with glomus jugulare tumors

2004 ◽  
Vol 17 (2) ◽  
pp. 63-67 ◽  
Author(s):  
Bruce E. Pollock
Keyword(s):  
Hearing Loss ◽  
Vocal Cord ◽  
Gamma Knife ◽  
Cranial Nerve ◽  
Vocal Cord Paralysis ◽  
Gamma Knife Surgery ◽  
Glomus Jugulare ◽  
The Mean ◽  
Primary Management

Object Microsurgical removal of glomus jugulare tumors is frequently associated with injury of the lower cranial nerves. To decrease the morbidity associated with tumor management in these patients, gamma knife surgery (GKS) was performed as an alternative to resection. Methods Between 1990 and 2003, 42 patients underwent GKS as the primary management (19 patients) or for recurrent glomus jugulare tumors (23 patients). Facial weakness and deafness were more common in patients with recurrent tumors than in those in whom primary GKS was performed (48% compared with 11%, p = 0.02). The mean tumor volume was 13.2 cm3; the mean tumor margin dose was 14.9 Gy. The mean follow-up period for the 39 patients in whom evaluation was possible was 44 months (range 6–149 months). After GKS, 12 tumors (31%) decreased in size, 26 (67%) were unchanged, and one (2%) grew. The patient whose tumor grew underwent repeated GKS. Progression-free survival after GKS was 100% at 3 and 7 years, and 75% at 10 years. Six patients (15%) experienced new deficits (hearing loss alone in three, facial numbness and hearing loss in one, vocal cord paralysis and hearing loss in one, and temporary imbalance and/or vertigo in one). In 26 patients in whom hearing could be tested before GKS, hearing preservation was achieved in 86 and 81% at 1 and 4 years posttreatment, respectively. No patient suffered a new lower cranial nerve deficit after one GKS session; the patient in whom repeated GKS was performed experienced a new vocal cord paralysis 1 year after his second procedure. Conclusions Gamma knife surgery provided tumor control with a low risk of new cranial nerve injury in early follow-up review. This procedure can be safely used as a primary management tool in patients with glomus jugulare tumors that do not have significant cervical extension, or in patients with recurrent tumors in this location.

Sign in / Sign up

Export Citation Format

Share Document