Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 69-year-old man presented with acute stridor and was found to have the superior vena cava syndrome and bilateral laryngeal paresis. A clinical diagnosis of malignancy was made, but before any definite investigations could be made an emergency operation had to be performed to relieve the trachea. On operation the patient was found to have a benign goitre. The literature on the subject is discussed. Since the great majority of cases with the superior vena cava syndrome is caused by malignant diseases, it has been suggested that in acute cases radiation therapy should be started without a microscopic diagnosis if necessary, but such a practice must be warned strongly against.
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PMID:Intrathoracic goitre with the superior vena cava syndrome, hoarseness and acute stridor. 57 39

The records of 90 cases of oculosympathetic paresis (1982-1991), 39 women and 51 men aged between 3 months and 82 years, were evaluated. The mean baseline anisocoria was 0.92 mm but did not exceed 2.4 mm. The mean difference in the position of the upper eyelid was 2.3 mm. Enophthalmus of 1 mm or more was found in only 25% and exophthalmus of 1 mm or more, in 18%. Exophthalmus or enophthalmus of more than 2 mm was not encountered. The cocaine test (5% solution in most cases) was performed in 85 cases and could be quantified in 65 cases. The average dilation of the involved pupil was 0.52 mm, whereas the normal pupil dilated 2.14 mm. The average postcocaine anisocoria was 2.54 mm. Hydroxyamphetamine 1% dilated the involved pupil in cases with presumed preganglionic lesions slightly more than the normal fellow pupil (2.39 mm and 2.09 mm respectively). The difference was significant (P < 0.05). In postganglionic lesions, the hydroxyamphetamine dilation was 0.57 mm. The hydroxyamphetamine test had a specificity of 90% for postganglionic lesions and 88% for preganglionic. An underlying acquired disease could be identified in 53 cases; 6 cases were congenital. In 37 cases (including the congenital ones), no cause was found. Among the 33 preganglionic lesions, only one malignant tumor was found, whereas 6 malignant tumors were encountered among the 20 postganglionic cases. Additional ocular motor palsies or other local signs were present in these 6 cases. Goiter was frequently associated with preganglionic Horner's syndrome.
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PMID:Horner's syndrome: a retrospective analysis of 90 cases and recommendations for clinical handling. 147 33

The results of operative treatment of 1247 patients with thyrotoxic goiter are presented. Thyrotoxic crisis occurred in 0.9%, paresis of the inferior laryngeal nerve--in 1.0%, parathyroid insufficiency--in 0.8%, hypothyrosis--in 2.3% of the patients operated on. The postoperative lethality was 0.2%.
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PMID:[The surgical treatment of patients with thyrotoxic goiter]. 179 44

Treatment of isolated, scintigraphically cold thyroid nodules in the thyroid gland by means of hemithyroidectomy ensures that, in patients with thyroid carcinoma, it is possible subsequently to carry out total thyroidectomy by means of an intervention limited to the contralateral surgically intact side. The object of the present investigation to assess whether this therapeutic strategy was rational and safe. Hemithyroidectomy was carried out in 67 patients on account of a "cold nodule" while the remaining 33 patients were submitted to operation on other indications. Out of the 67 patients, one (2%) had a papillary carcinoma, 53 (79%) had follicular adenomata, 12 (18%) had nodular goitre and one (2%) had Hashimoto's thyroiditis. In the entire material, one case (1%) of permanent hypocalcaemia was encountered. None of the patients developed paresis of the recurrent laryngeal nerve. Reoperation proved necessary in one patient (1%) on account of postoperative heamorrhage. It is concluded that hemithyroidectomy is a rational primary method of treatment in cases with suspected malignant disease in the thyroid gland. Non-neoplastic conditions may be excluded with reasonable certainty by preoperative clinical assessment and thyroid scintigraphy and ultrasound scanning. The intervention is safe and every thyroid surgeon should be capable of performing the operation.
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PMID:[Hemithyroidectomy. A consecutive series of 100 patients]. 202 13

Between 1979-1988, 7566 operations for benign diseases of the thyroid gland were performed. The frequency of the paresis of the recurrent nerve examined between the third and fifth postoperative day was 5.2% for patients and 3.2% for resected lobes. The incidence was correlated to performed operative procedure (enucleation, subtotal resection, lobectomy) to size (weight of specimen) and to the expansion of the goiter (substernal, intrathoracic, retrotracheal) as well as to sex. These factors influence the risk of injury with high statistic significance. The side of resection and the ligature of the thyroid inferior artery also influenced the rate of recurrent nerve pareses. Age of patient and morphology of the thyroid disease did not cause an increasing risk of nerve injury.
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PMID:[Risk factors in recurrent nerve paralysis: a statistical analysis of 7566 cases of struma surgery]. 203 93

The unusual case of a patient with goiter and left faciobrachiocrural paresis due to right temporoparietal infarction is reported. Cerebral angioscintigram and arteriography showed a brachiocephalic and right subclavian stenosis secondary to compression by an extended thyroid nodule.
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PMID:Vascular compression from goiter as an unusual cause of cerebrovascular accident. 238 5

Experiences are reported connected with surgical treatment of goitre in 84 patients aged over 65 years. Deaths occurred exclusively in patients with thyroid malignant tumours, and the most frequent postoperative complication was paresis of the recurrent laryngeal nerve. Owing to adequate preparation of patients for operation and correct postoperative management the old age of the patient, is not increasing significantly the surgical risk.
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PMID:[Surgical treatment of goiter in older people]. 263 32

None of the 335 patients thyroidectomized for hyperthyroidism in our department of surgery between 1972 and 1982 died as a consequence of the operation. Reassessment of 226 of these patients by questionnaire 68 +/- 25 (SD) months after thyroidectomy revealed the following complications: postoperative paresis of the recurrent nerve (9%), persistent change of voice (2%), and persistent hypoparathyroidism (3.5%). 91 patients underwent a follow-up investigation 74 +/- 33 months after thyroidectomy. Only one had recurrent hyperthyroidism but 6 had a recurrence of the goiter. Patients with recurrent goiters had a significantly higher frequency of increased serum thyroglobulin levels than patients without goiters. These results emphasize the effectiveness of surgical therapy in hyperthyroidism, and suggest that serum thyroglobulin might be a useful predictor for goiter recurrence.
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PMID:[Surgical treatment of hyperthyroid struma: surgery results, postoperative long-term course and study of a factor connected with recurrences]. 384 Jun 5

Eighteen consecutive cases of intrathoracic goitres operated in an ENT department during a four-year period from 1977-1981 are presented. Massive intrathoracic extension, with at least half of the gland located below the top of the sternum, was seen in all cases. Seventy-eight per cent of the patients had respiratory symptoms, which, in most cases, was so extreme that periodic or manifest stridor was present. The gland could be extirpated through a wide Kocher's incision in all cases. There was no mortality, only a single case of hypoparathyroidism and no recurrent nerve paresis or other complications. Traditionally operation of intrathoracic goitre is performed in thoracic surgical departments. Sternal splitting or lateral thoracotomy, however, is only necessary in a very few cases. It is concluded that surgical treatment of patients with large intrathoracic extension can be performed with advantage in ENT departments by surgeons experienced in head and neck cancer surgery using the operating microscope to lessen risk of damage to the recurrent laryngeal nerves.
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PMID:Intrathoracic goitre. Surgical treatment in an ENT department. 664 62

Out of 19 patients with unilateral laryngeal paresis, 8 patients developed the paresis early after strumectomy, 4 had lung tumors, 2 tumors of the esophagus, 2 stab cervical wounds, 2 aortal arch dilatation, 1 patient had retrosternal goiter. Peripheral paralysis of the recurrent nerve is caused most frequently by the nerve compression in the thoracic cavity. The disease may be diagnosed accurately by ascertaining the causes underlying the nerve compression in the thoracic cavity using x-ray, ultrasound and computed tomography. Early diagnosis of mediastinal and pulmonary tumors enable conservative surgery with good functional results.
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PMID:[Unilateral laryngeal paresis as an early symptom of recurrent nerve compression caused by tumor or trauma]. 772 84


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