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

Eight out of 12 unselected patients with Shy-Drager syndrome were found to have severe bilateral paresis of vocal cord abduction by fibre-optic laryngoscopy. This commonly presented as increased snoring followed by episodes of inspiratory and expiratory stridor and sometimes by sleep apnoea. Respiratory failure eventually developed in four cases and was reversed by tracheostomy. In another patient tracheostomy relieved severe attacks of sleep apnoea. This complication was not necessarily associated with advanced disease, and it should be considered in all patients with Shy-Drager syndrome as appropriate treatment can lead to a useful extension of life.
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PMID:Vocal cord paralysis in the Shy-Drager syndrome. 42 62

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

Familial vocal cord dysfunction is a rare condition that has been reported in only a few instances. This is a report of identical male twins, both of whom had congenital bilateral abductor vocal cord paresis associated with finger deformities. The vocal cord paresis progressed to paralysis that required tracheotomy, then returned to a slowly resolving paresis during which the vocal cords had uncoordinated motion generally known as synkinesis. Another male sibling and the mother had a history of stridor during infancy and finger deformities. Several other relatives had digital abnormalities, and an infant first cousin with finger abnormalities required a tracheotomy for vocal cord paralysis.
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PMID:Familial vocal cord dysfunction associated with digital anomalies. 220 54

We describe a patient with olivopontocerebellar atrophy (OPCA) who was referred for alleged "snoring." Polysomnogram with video and audio monitoring revealed that the patient actually had nocturnal stridor causing repetitive oxygen desaturations. Direct laryngoscopy while awake showed a unilateral vocal cord paralysis. The nocturnal stridor persisted after unilateral vocal cord pinning, suggesting that the patient had probably been experiencing bilateral vocal cord paresis while asleep. We conclude that state-dependent vocal cord dysfunction may be severe in OPCA and related multiple system atrophy. Nocturnal stridor has many causes and may mimic snoring and obstructive sleep apnea syndrome. Polysomnography with audio and video recordings are necessary to make the diagnosis.
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PMID:Nocturnal stridor in olivopontocerebellar atrophy. 226 79

Vocal cord paralysis or paresis as the initial presenting symptom for intracranial tumors in children are rare. Recently, two pediatric patients who were later diagnosed as having intracranial tumors presented with the symptom of voice changes and stridor. Telescopic examination revealed bilateral vocal cord paresis and paralysis as demonstrated by video recordings. The majority of pediatric brain tumors present with both generalized and localized complaints; however, by discussing these two rare cases, we hope to underscore the importance of a thorough workup of the paralyzed or paretic vocal cords.
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PMID:Central vocal cord paralysis and paresis presenting as laryngeal stridor in children. 229 96

The nasogastric tube can produce sudden, life-threatening bilateral vocal cord paralysis and is often an unrecognized cause of this clinical entity. The pathophysiologic mechanism is thought to be paresis of the posterior cricoarytenoid muscles secondary to ulceration and infection over the posterior lamina of the cricoid. Since our initial report of this entity in 1981, several cases have been photo-documented. Study of whole organ sections of an involved larynx have demonstrated the histopathology. Diabetic renal transplant patients appear to be particularly susceptible to the condition, due to prolonged gastroparesis and requirement for nasogastric tube drainage. Esophagoscopy should be performed promptly in these patients when pharyngodynia, hoarseness, or evolving stridor present in the postoperative period.
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PMID:The nasogastric tube syndrome. 189 58

The information presented in this article demonstrates that unilateral or bilateral vocal cord paresis or paralysis in infants and children is difficult to diagnose and difficult to manage. In an attempt to provide the otolaryngologist with a concise set of relevant guidelines, the following rules for management are presented here. 1. Suspect bilateral abductor vocal cord paralysis (BAVP) when a neonate or infant presents with high-pitched inspiratory stridor and evidence of airway compromise. Factors that should increase the suspicion of BAVP include associated Arnold-Chiari malformation; congenital anatomic abnormality involving the mediastinum (for example, tracheoesophageal fistula, vascular ring, other vascular anomalies); dysmorphic syndromes, especially those involving brainstem dysfunction; and manifest findings indicative of neuromuscular disorder. The neonate or infant with Arnold-Chiari malformation and inspiratory stridor has bilateral abductor vocal cord paralysis until proven otherwise. 2. Suspect unilateral vocal cord paresis or paralysis in an infant or child with hoarse voice, low-pitched cry, or breathy cry or voice. The infant who develops mild stridor and hoarse cry following surgical repair of a patent ductus arteriosus or tracheoesophageal fistula has a unilateral vocal cord paralysis until proven otherwise. 3. Direct laryngoscopy with the flexible fiberoptic nasopharyngolaryngoscope and photodocumentation using a videocassette recorder offers the best method for diagnosis of vocal cord paresis or paralysis. Additional diagnostic studies that may be helpful include radiographic studies, CT scan, MRI scan, electromyography of the larynx, and, in older children, stroboscopy. 4. In using a flexible direct laryngoscope be careful not to interpret all motions of the vocal cords or arytenoids as evidence to preclude the diagnosis of vocal cord paralysis or paresis and be careful not to mistake the anterior intraluminal portion of a normal cricoid for an "anterior glottic web." 5. Tracheotomy is often required in order to assure adequate airway during infancy for children with BAVP. However, with the advent of sophisticated cardiorespiratory monitoring equipment and methods for monitoring blood oxygen and carbon dioxide levels, tracheotomy can be delayed until attempts have been made to improve the adequacy of the airway with neurosurgical intervention or other procedures.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Vocal cord paralysis. 265 84

Flexible laryngoscopy was performed 453 times on 264 patients 4 years of age or younger. Sixty-five percent were under 6 months of age. Stridor was the indication for laryngoscopy in 60% of the patients. Problems secondary to intubation and poor voice each were indications in 12%. The most common finding was laryngomalacia, followed by laryngeal edema, normal larynges, and vocal cord paralysis or paresis. Subglottic stenosis was diagnosed in 17 patients. Flexible laryngoscopy is a relatively noninvasive, safe, and effective technique for examining the larynx of infants and young children.
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PMID:Flexible laryngoscopy in neonates, infants, and young children. 381 92

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

Twelve patients with Shy-Drager syndrome (SDS) presenting symptoms of multiple nervous system atrophy and orthostatic hypotension were examined for laryngeal movement disorders and vocal impairment in speech. Vocal fold abductor paresis was found in 11 patients and was bilateral in 10. Speech task performance was recorded in SDS patients, Parkinson patients and age- and sex-matched controls. Trained listeners with inter-rated reliability greater than or equal to .85 judged each recording on 20 attributes while blind to speaker identity. SDS patients had a breathy and strained voice quality, reduced loudness, monopitch and monoloudness, imprecise consonants, variations in rate and rate-slowing, suggesting a flaccid type of dysarthria. In comparison with Parkinson patients, SDS patients had excess vocal hoarseness, intermittent glottal fry and a slow and deliberate speaking rate. Orthostatic hypotension, laryngeal stridor, hoarseness, intermittent glottal fry and slow speech rate were found to be discriminating symptoms of SDS.
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PMID:Vocal fold paresis in Shy-Drager syndrome. 682 89


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