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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The combined paresis of the musculus trapezius and musculus serratus anterior results in a positional change and major loss of active mobility of the shoulder girdle. This greatly disturbs the mechanics of movement of the upper arm. The individual signs include a lowering of the shoulder blade in ventro-caudal direction in accordance with the weight of the arm, as a result of the absence of muscular restraint. In this position, the scapula exercises so to say an adducting action on the upper arm, so that this will usually not exceed an abduction of about 40 degrees, in relation to the perpendicular line of C7, althoug it may be freely mobile in the glenohumeral joint. Increase of elevation of the upper arm and of the force exercised by the musculature acting on the glenohumeral joint can be achieved via a correction of the position of the shoulder girdle associated with simultaneous stabilization of the shoulder blade at the posterior thoracic wall. Using an actual case as basis, scapulothoracic arthrodesis in the modification according to Spira is described as a method to correct the position of the shoulder blade and to stabilize the scapula. Other possibilities of stabilization in the form of musculature transpositions and paresis operations are discussed. The article also comments on the indication of scapula fixation.
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PMID:[Treatment of the combined musculus trapezius/serratus anterior paresis with scapulothoracal arthrodesis according to Spira (author's transl)]. 54 54

In brachial plexus paresis with partial sensory sparing in the upper arm and complete motor paralysis we amputate through the humerus at the distal limit of sensation. The remaining proximal humerus is fixed by an arthrodesis of the shoulder joint, combined with a varus-osteotomy below the head. This increases with axillary space, facilitates the fitting of a prosthesis and improves care of the skin in this critical area. It also improves the outline of the shoulder the muscles of which shrink.
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PMID:[Paresis of the brachial plexus: subcapital varus osteotomy, arthrodesis of shoulder joint and above-elbow amputation (author's transl)]. 93 Feb 53

A case of postintubation laryngotracheal injury is described. The paramedian position of the vocal cords was found to be a consequence of cicatrix in the area of the posterior commissure, and by a luxation with ankylosis of the right cricoarytenoid joint. Paresis of the recurrent laryngeal nerve was excluded by electromyography. Multiple incisions of the cicatrix failed to correct the problem, whereas subsequent incision followed by intensive therapy with fludrocortisone and hyaluronidase was successful in management. In administering the medication, a new simplifed method for translaryngeal injection is described.
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PMID:[Combined treatment of a cicatrised post-intubation complication with surgery and medication summary (author's transl)]. 97 97

1. In every case of a vocal cord paresis, its cause should be carefully sought. 2. "Pseudopareses" of the vocal cord can be excluded by electromygraphy. 3. In all cases of neurogneic vocal cord praeses and regardless of aetiology, immediate phoniatric training is indicated for acceleration of nerve regeneration as well as electrostimulation for the prevention of muscular atrophy and ankylosis of the cricoarytenoid joint. 4. If such therapy is neglected, the functional results of spontaneous regeneration, neurolysis and nerve plasty are doubtful. 5. If in cases of mechanical lesions of the recurrent nerve one decides to operate, electromyography of the larynx and a mobility test of the cricoarytenoid joints to be done first. 6. Compression or overstretching of the nerve should be followed by neurolysis after 5 months, unless the nerve has regenerated spontaneously. 7. When the recurrent nerve has had to be served it should be repaired by anastomosis as soon as possible. 8. Judging by our experience in regeneration of the laryngeal nerves, we feel that operations for opening or closure of the glottis are indicated only after 2 years.
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PMID:[Indication and timing of conservative surgery of peripheral neurogenic vocal cord pareses (author's transl)]. 108 85

The complete immobilisation of a limb alone can lead to the formation of oedema. Whereas the oedema secondary to inactivity induced by immobilisation is completely reversible, and will only lead to tissue damage in the longterm, neglect of oedema secondary to inactivity in the presence of central and peripheral paresis (apoplectic insult, paraplegia, damage to the plexus brachialis) may entail serious consequences due to the danger of tissue fibrosis. With paresis of an extremity, the lymphovenous return is impaired by two decisive factors: increased hydrostatic pressure in the distal limb segment, and absence of the muscle pump. In flaccid paresis, where there is low muscle tone and no muscle pump action, there is also a low venous tone and the resultant hydrostatic pressure is especially high. Venous stasis in the sub- and prefascial veins leads to increased protein loss from the venous limb of the capillaries and the venules. Compensation initially occurs in the prefascial lymph outflow region (latent oedema) which becomes decompensated if overloaded (visible oedema). Fibrosis of the subcutis and trophic skin changes are the result. In spastic paresis the regional subfascial lymphatic system responds with lymphangiospasm. Where the sympathetic innervation is interrupted (e.g. brachial plexus paralysis) there is passive hyperaemia of the terminal vessels with vascular dilatation and lymphangioparalysis. Insufficiency of the vascular walls results in an accumulation of protein in the tissues, which ultimately ends in fibrosis with ankylosis and shortening of the tendons and muscles. The early administration of complex physical decongestion therapy with manual lymphatic drainage can prevent this state.
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PMID:[Neurologic principles of edema in inactivity]. 128 27

In this paper the surgical management of TMJ dysfunction-ankylosis and arthropathies-is described. The surgical techniques and the necessity of wide exposure are pointed out. Only thus are correct reshaping of the condyle, repair of the disc and radical resection of ankylotic bone tissue possible. The indication for prosthetic substitution to be interpositioned in cases with discal atrophy and perforation is discussed. There were no cases of facial paresis and no recurrence of ankylosis. The results, in regard to the functional aspects, confirm the efficiency of the methods described.
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PMID:TMJ dysfunction: surgical management and reconstruction. 259 17

Vocal cord paralysis as cause of an immobility of the vocal cord following endotracheal intubation is often a misdiagnosis. The differential diagnosis is pointed out to distinguish between paresis and ankylosis of the cricoarytaenoid joint, interarytaenoid fibrosis or luxation of the arytaenoid. The development of these disturbances following endotracheal intubation and their therapy are presented.
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PMID:[Differential diagnosis of vocal cord immobility after intubation]. 269 Jul 99

Trauma is the major cause for temporomandibular joint (TMJ) ankylosis. 20 patients with posttraumatic TMJ ankylosis were surgically treated with interposition of lyophilized homologous cartilage between the newly-formed condylar head and the articular fossa. The follow-up of all patients revealed a correct function of the TMJ. A meticulously performed surgical exposure is decisive for the prevention of facial nerve paresis.
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PMID:[Results following surgical treatment of post-traumatic temporomandibular joint ankylosis]. 279 57

Between 1974 and 1986 a total of 123 patients with a spastic or spastic athetotic paresis of the upper limb underwent surgery. The interval between surgery and follow-up examination was between one and 13 years. There were 73 cases of hemiparesis and 50 dipareses or tetrapareses due to perinatal cerebral paresis and 35 cases due to a variety of causes. The patients were aged between 6 and 58 years, the majority between 8 and 28 years. All contractures in the arm and hand region were treated at a single sitting. The sole exception to this was surgery for swan-neck deformity of the long fingers. In none of the cases was a wrist arthrodesis indicated. As regards the elimination of the previously existing malpositions, some of which were severe, and the cosmetic outcome, the results were good in all cases. The postoperative reduction was also preserved through the subsequent years, until completion of growth. Also, the difference in growth between flexors and extensors had no detectable negative influence on the long-term results of surgery. Only in a few isolated cases was limited revisional surgery necessary to improve the result as regards extension in the elbow joint and the posture of the wrist joint, which it had not been possible to treat satisfactorily at the first sitting. Two patients with a pronounced athetotic component manifested unsatisfactory results in several respects, or overcorrection of extension in the wrist joint: special caution is called for here. As far as necessary, corresponding corrective surgery was performed simultaneously on the lower limbs.
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PMID:[Results of hand surgery operations in spastic-athetotic paresis]. 321 63

A patient with spinobulbar poliomyelitis had residual dysfunction of the ninth and tenth cranial nerves, which produced bilateral vocal cord paresis and recurrent aspiration. Critical glottic stenosis developed 28 years after the initial episode of poliomyelitis; this course appeared to be explained by fibrosis of the intrinsic laryngeal muscles and ankylosis of the right cricoarytenoid joint. Thus it appears that significant upper airway obstruction may develop as a late complication in patients with stable neurologic deficits and chronic immobility of the vocal cords.
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PMID:Vocal cord paresis and glottic stenosis: a late complication of poliomyelitis. 342 8


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