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

The anatomy and physiology of the larynx are discussed. The larynx is a dynamic structure, and motion pictures are helping to document and to clarify its dynamic behavior in the presence of diseases such as paresis and paralysis. The recognizable distinguishing features of unilateral and bilateral superior nerve paralysis are discussed in detail. These lesions often have gone unrecognized in the past and the patients mistakenly have been referred to the speech therapist with an incorrect diagnosis of "functional voice disorder."
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PMID:Superior laryngeal nerve paralysis an often overlooked entity. 85 93

A psychogenic voice disorder co-occurred or evolved with the symptoms and signs of unilateral superior laryngeal nerve paresis. We speculated that the former was a manifestation of a musculoskeletal tension or conversion reaction disorder, whereas the latter was a sequela to a self-limiting inflammatory process. Voice therapy proved effective for alleviating the psychogenic dysphonia after the signs of the neuropathy had resolved, whereas psychotherapy offered strategies for stress management. A multidisciplinary approach to this patient provided for differential diagnosis and efficacious treatment.
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PMID:A case of superior laryngeal nerve paresis and psychogenic dysphonia. 268 99

Psychogenic dysphonia refers to loss of voice where there is insufficient structural or neurological pathology to account for the nature and severity of the dysphonia, and where loss of volitional control over phonation seems to be related to psychological processes such as anxiety, depression, conversion reaction, or personality disorder. Such dysphonias may often develop post-viral infection with laryngitis, and generally in close proximity to emotionally or psychologically taxing experiences, where "conflict over speaking out" is an issue. In more rare instances, severe and persistent psychogenic dysphonia may develop under innocuous or unrelated circumstances, but over time, it may be traced back to traumatic stress experiences that occurred many months or years prior to the onset of the voice disorder. In such cases, the qualitative nature of the traumatic experience may be reflected in the way the psychogenic voice disorder presents. The possible relationship between psychogenic dysphonia and earlier traumatic stress experience is discussed, and the reportedly low prevalence of conversion reaction (4% to 5%) as the basis for psychogenic dysphonia is challenged. Two cases are presented to illustrate the issues raised: the first, a young woman who was sexually assaulted and chose to "keep her secret," and the second, a 52-year-old woman who developed a psychogenic dysphonia following a second, modified thyroplasty for a unilateral vocal fold paresis.
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PMID:Psychogenic voice disorders and traumatic stress experience: a discussion paper with two case reports. 1451 54

A retrospective chart review was performed at the senior author's voice disorder clinic to report the symptoms, signs, and laryngeal electromyography (LEMG) data of patients presenting with vocal fold paresis (VFP) in a tertiary laryngology academic practice over a 4-year period. Medical records of 739 patients presenting to the clinic with a chief complaint of dysphonia (for 2000-2004) were assessed. History intake forms, strobovideolaryngoscopy images, and LEMG reports were reviewed for all patients with a clinical diagnosis of VFP. Of the 739 patients presenting to the clinic with voice complaints, 195 were initially diagnosed with either vocal fold paralysis or VFP (26.4%). Only 13 out of 739 patients (1.8%) with voice complaints were diagnosed with LEMG-confirmed unilateral or bilateral VFP. The most common findings on strobovideolaryngoscopy were vocal fold bowing (70%), incomplete closure (62%), and increased vibratory amplitude (38%). Seventy percentage of the patients had unilateral VFP, predominantly isolated recurrent laryngeal nerve (RLN) disease. Only 9% had unilateral superior laryngeal nerve (SLN) involvement. The most common LEMG abnormality was reduced recruitment of motor units. In our voice center, VFP was a relatively uncommon diagnostic entity. Despite the low prevalence, VFP needs to be considered in all patients who present with dysphonia. Further study is needed to examine the prevalence of "abnormal" LEMG studies in an asymptomatic control population, and to determine the utility of LEMG in the evaluation and management of dysphonia. In the same way that strobovideolaryngoscopy has been critically evaluated in the past, there is also a need to determine how commonly LEMG contributes essential data which leads to a change in the patient's management and/or ultimate vocal outcome.
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PMID:Vocal fold paresis: clinical and electrophysiologic features in a tertiary laryngology practice. 1832 45

Paralytic dysphonia is a voice disorder created as a result of neurogenic injury of the neuromuscular larynx organ, owing to the laryngeal nerves paralysis or paresis. It is of the most serious voice producing larynx organ lesions. The paper presents the case of 53-year-old patient with a total neurogenic traumatic left vocal cord paralysis. The usefulness of an early phoniatric and logopedic rehabilitation by means of breathing and kinetic exercises, mechanotherapy and a vocalistic and phonetic method in order to obtain the improvement of the quality of voice in paralytic dysphonia was analysed. The complex subjective and objective foniatric assessment of the voice quality before and after the rehabilitation indicated the usefulness of applied methods and the improvement of all parameters of the voice quality in the analyzed case.
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PMID:[Rehabilitation of voice at paralytic dysphonia--case report]. 1911 42