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Vocal folds paralysis

H Gurbuz Aytuluk, O Aktas
Cranial nerve palsy is a rare neurological complication of epidural and subarachnoid blocks. Most of these complications are attributed to secondary intracranial hypotension due to cerebrospinal fluid leakage following dural puncture. Vocal fold paralysis (VFP) seems more likely to be overlooked and underreported due to delayed onset of symptoms and lack of attribution of dysphonia to spinal anesthesia. Therefore, VFP can often be missed and described as idiopathic. This article describes a case of VFP due to vagus nerve injury following subarachnoid block...
October 12, 2018: Der Anaesthesist
Maria Catalina Espinosa, Julina Ongkasuwan
PURPOSE OF REVIEW: Ansa to recurrent laryngeal nerve reinnervation, otherwise known as a nonselective laryngeal reinnervation (NSLR), is growing in popularity for the management of pediatric unilateral neuronal vocal fold movement impairment (VFMI). In this chapter, we will review the current treatment options for neuronal VFMI and role that NSLR plays in the treatment algorithm. RECENT FINDINGS: In 2018, Bouhabel and Hartnick published a survey of fellowship trained pediatric otolaryngologists and found an increasing comfort level with NSLR...
October 8, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Y N Gao, S C Chen, D H Chen, M Li, W Wang, F Liu, M H Zhu, H L Zheng
Objective: To discuss the long-term efficacy of laryngeal reinnervation using the anterior root of the ansa cervicalis in the treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. Method: From January 2010 to January 2016, a total of 39 UVFP patients who underwent ansa cervicalis anterior root-to-recurrent laryngeal nerve (RLN) anastomosis and who had suffered nerve disfunction for 6 to 24 months were enrolled as UVFP group.Another 39 age and gender matched normal subjects served as control group...
September 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Hung-Chun Chen, Yu-Chen Pei, Tuan-Jen Fang
OBJECTIVES/HYPOTHESIS: We aimed to identify the risk factors for iatrogenic unilateral vocal fold paralysis (UVFP) caused by thyroid surgery, to allow the identification of patients requiring nerve-protection procedures and monitoring technologies. STUDY DESIGN: Retrospective case study in a medical center. METHODS: Patients who underwent thyroid surgery from April 2011 to February 2016 and who were diagnosed with UVFP by laryngoscopy and laryngeal electromyography were included...
October 3, 2018: Laryngoscope
Anne Hseu, Nohamin Ayele, Kosuke Kawai, A Lindsay Frazier, Jennifer Mack, Karen Watters, Roger Nuss, Reza Rahbar
No abstract text is available yet for this article.
November 2018: International Journal of Pediatric Otorhinolaryngology
Chloe Walton, Paul Carding, Erin Conway, Kieran Flanagan, Helen Blackshaw
OBJECTIVES: Unilateral vocal fold paralysis (UVFP) typically results in marked changes in voice quality and performance and has a significant impact on quality of life. Treatment approaches generally aim to restore glottal closure for phonation and improve vocal function. There are a wide range of voice outcome measures that are available to measure the treatment effect. Careful selection of voice outcome measures is required to ensure that they are adequate for purpose and are psychometrically sound to detect the treatment effect...
September 19, 2018: Laryngoscope
Matthew G Crowson, Betty C Tong, Hui-Jie Lee, Yao Song, David H Harpole, Harrison N Jones, Seth Cohen
OBJECTIVES/HYPOTHESIS: Vocal fold paralysis/paresis (VFP) is an uncommon but serious complication following esophagectomy. The objectives of this study were to: 1) identify the prevalence of VFP and associated complications after esophagectomy in the United States, and 2) determine the utilization and otolaryngology-head and neck surgery/speech-language pathology (OHNS/SLP) and predictors of such utilization in the management of these patients. STUDY DESIGN: Retrospective database analysis...
September 19, 2018: Laryngoscope
Shekhar K Gadkaree, Alexander Gelbard, Simon R Best, Lee M Akst, Martin Brodsky, Alexander T Hillel
Objective To test the hypothesis that the etiologies of bilateral vocal fold mobility impairment (BLVFI), bilateral vocal fold paralysis (BVFP), and posterior glottis stenosis (PGS) have distinct clinical outcomes. To identify patient-specific and procedural factors that influence tracheostomy-free survival. Study Design Retrospective cohort study. Setting Johns Hopkins Medical Center from 2004 to 2015. Subjects and Methods Case series with chart review of 68 patients with PGS and 17 patients with BVFP. Multiple logistic regression analysis determined factors associated with airway prosthesis dependence at last follow-up and the procedural burden (defined as number of operative procedures per year)...
September 18, 2018: Otolaryngology—Head and Neck Surgery
Cara Sauder, Tanya Eadie
OBJECTIVE/HYPOTHESIS: To determine whether the presence and accuracy of a laryngeal medical diagnosis affects novice listeners' judgments of dysphonia. STUDY DESIGN: Prospective, within subjects, modified factorial experimental design. METHODS: Twenty-six speakers with dysphonia and four normophonic speakers provided speech recordings. Forty novice clinicians evaluated speech samples for roughness and breathiness using 100-mm visual analog scales in two conditions...
September 5, 2018: Journal of Voice: Official Journal of the Voice Foundation
Jonathan H Sin, Hira Shafeeq, Zachary D Levy
PURPOSE: The uses of nimodipine for otolaryngic indications are reviewed, and recommendations for its use in clinical practice are provided. SUMMARY: Nimodipine is currently indicated for the improvement of neurologic outcomes in adult patients with aneurysmal subarachnoid hemorrhage (aSAH). However, other oral and i.v. calcium channel blockers have not exhibited the same beneficial effects in patients with aSAH, leading clinicians to believe that nimodipine possesses unique neuroprotective effects in addition to its calcium channel-blocking and vasodilatory properties...
September 15, 2018: American Journal of Health-system Pharmacy: AJHP
Minsu Kwon, Mi Rye Bae, Yoon Se Lee, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim
OBJECTIVES: This study aimed to compare the characteristics of idiopathic unilateral vocal fold paralysis (IUVFP) in elderly versus younger patients, including the diagnostic yield of computed tomography (CT) scans for identifying the structural causes of IUVFP. METHODS: We retrospectively analyzed medical records of the patients initially diagnosed with IUVFP in a single referral tertiary hospital. We compared patients' baseline characteristics, initial symptoms, laryngoscopic findings, and prevalence of structural causes on CT scans with respect to age (younger, <65 years vs older, ⩾65 years)...
September 5, 2018: Annals of Otology, Rhinology, and Laryngology
Ashwini Joshi, Christopher R Watts, Jeremy Hathway
OBJECTIVE: The purpose of this study was to examine measures of phonation quotient (PQ) in two groups of persons with voice disorders using three different aerodynamic instruments representing low-tech and high-tech options. STUDY DESIGN: Prospective, repeated measures design. METHODS: Two groups of patients with a diagnosis of vocal fold paralysis/paresis (n = 9) or benign vocal fold lesions (n = 8) were assessed for maximum phonation time and vital capacity obtained from three aerodynamic instruments: a hand-held analog windmill-type spirometer; a hand-held digital spirometer; and the Phonatory Aerodynamic System (PAS), Model 6600...
August 29, 2018: Journal of Voice: Official Journal of the Voice Foundation
Claudio Storck, Martin Lüthi, Flurin Honegger, Fabian Unteregger
OBJECTIVES/HYPOTHESIS: Medialization thyroplasty (MT) has become a prominent method for treating glottal insufficiency. This study aimed to visualize the biomechanical influence of a medialization implant on arytenoid cartilage, particularly on the length and level of paralyzation in the vocal fold, in patients with unilateral vocal fold paralysis. STUDY DESIGN: Prospective study. METHODS: We recruited 15 patients (10 men, 5 women) with unilateral vocal fold paralysis that underwent MT with a Montgomery® thyroplasty implant...
August 29, 2018: Journal of Voice: Official Journal of the Voice Foundation
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Akhilesh Kumar Singh, Harsh Vardhan, Kranti Bhavana, Ditipriya Bhar
Background and Aims: The preservation of recurrent laryngeal nerve (RLN) is an essential part of thyroid surgery. The various methods to test the normal functionality of vocal cords (VCs) include direct visualisation under the fiber bronchoscope, indirect laryngoscopy, laryngeal muscles electromyography, computed tomography (CT), and magnetic resonance imaging (MRI). We aimed to assess the usefulness of ultrasound (USG) in the examination of VC morphology and movement. Methods: After Institutional Ethical Committee (IEC) clearance, 65 American Society of Anesthesiologists physical status I/II patients between the age group 18 and 60 years scheduled for thyroid surgery were enrolled in this observational study...
August 2018: Indian Journal of Anaesthesia
Neel K Bhatt, Patrik Pipkorn, Randal C Paniello
INTRODUCTION: Unilateral vocal fold paralysis (UVFP) without an identifiable cause is termed idiopathic unilateral vocal fold paralysis (IUVFP). Some authors have postulated that select cases of IUVFP have a viral etiology, but the causality has not been established. We set out to review institutional cases of IUVFP and determine if there is a correlation between upper respiratory infection symptoms and presentation of IUVFP. METHODS: Cases of IUVFP were reviewed over a 10-year period (2002-2012)...
October 2018: Annals of Otology, Rhinology, and Laryngology
Catherine F Sinclair, Maria J Téllez, Sedat Ulkatan
BACKGROUND: Continuous vagal intraoperative neuromonitoring (IONM) currently requires placement of a vagal nerve electrode. Herein, we present data from 100 patients (134 nerves-at-risk) monitored continuously during neck endocrine surgeries using a noninvasive, new methodology that solely utilizes endotracheal tube electrodes to simultaneously stimulate laryngeal mucosa and record a laryngeal adductor reflex continuous IONM (LAR-C-IONM) response. METHODS: The laryngeal adductor reflex (LAR) was elicited by electrical laryngeal mucosal stimulation on the side contralateral to the operative field using endotracheal tube electrodes...
August 18, 2018: Head & Neck
Abdul-Latif Hamdan, Marwan Rizk, Elie Khalifee, Georges Ziade, Maher Kasti
Objective: To report voice outcome measures after injection laryngoplasty using the transnasal or transoral flexible endoscopic technique. Methods: A retrospective review of all patients who underwent flexible endoscopic injection laryngoplasty between June 2010 and August 2016 was carried out. Only those patients who had pre- and post-injection voice outcome measures recorded were included. Voice outcome measures recorded included perceptual voice evaluation using GRBAS, Voice Handicap Index-10 (VHI-10), maximum phonation time (MPT) and closed quotient (CQ) before and after treatment...
June 2018: World Journal of Otorhinolaryngology—Head and Neck Surgery
B Kohnen, C Schürmeyer, T H Schürmeyer, P Kress
PURPOSE: Thyroid surgery is mainly performed by general surgeons (GS). The aim of this study is to evaluate the safety and efficiency of thyroid surgery by ENT/head and neck surgeons (ENT), especially regarding the incidence of vocal fold palsy (VFP). METHODS: We retrospectively analysed 3509 patients (69.0% female) who underwent surgery for benign thyroid diseases (56.8% nodular goitre, 18.6% inactive nodes, 14.0% thyroid autonomy, 7.0% Graves' disease). Operations were mainly performed with intraoperative neuromonitoring by GS (n = 1933) or physicians trained for head and neck surgery (n = 1576)...
September 2018: European Archives of Oto-rhino-laryngology
Supraja Anand, Lisa M Kopf, Rahul Shrivastav, David A Eddins
BACKGROUND: A limited number of experiments have investigated the perception of strain compared to the voice qualities of breathiness and roughness despite its widespread occurrence in patients who have hyperfunctional voice disorders, adductor spasmodic dysphonia, and vocal fold paralysis among others. OBJECTIVE: The purpose of this study is to determine the perceptual basis of strain through identification and exploration of acoustic and psychoacoustic measures...
July 28, 2018: Journal of Voice: Official Journal of the Voice Foundation
Marina Gilman, Carissa Maira, Edie R Hapner
OBJECTIVE: Aerodynamic measures of voice have historically been acquired using sustained phonation tasks. This study seeks to determine whether there are differences in airflow during sustained phonation (MFs), in running speech (MFrs), or during phonation in running speech (MFvrs). We also seek to determine whether these patterns are diagnostically significant. METHODS: Data were collected on 40 subjects (15 men, 25 women), ages 20-79, with a mean age of 53 in this prospective study...
July 26, 2018: Journal of Voice: Official Journal of the Voice Foundation
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