IMPAIRED MOBILITY OF VOCAL FOLDS – DIAGNOSTIC PROCEDURES AND TREATMENT, part 2
Abstract
Paresis or paralysis of one or both vocal cords affects phonation, swallowing and breathing. The major cause for reduced mobility or even immobility is innervation damage, less often mechanical disorder.
The main procedures in the diagnostics of disordered vocal fold mobility are indirect laryngoscopy and videoendostroboscopy. Different imaging techniques (especially computerized tomography) are of great value in searching for a cause of the impaired mobility.
In unilateral vocal fold immobility, the treatment is focused on the improvement of voice quality and the prevention of aspiration during swallowing. In bilateral paralysis, it is crucial to find a balance between effective breathing and sufficient voice quality. The treatment of unilateral paralysis is started with voice therapy and swallowing rehabilitation. If these procedures are not enough surgical treatment for the medialization of the paralyzed vocal fold is applied. In the case of breathing difficulties in bilateral vocal fold immobility there is a possibility of surgical lateralization of one or both folds or a surgical excision of a part or the entire vocal fold. Surgical reinnervation, functional electrostimulation of certain laryngeal muscles and gene therapy are developing treatment modalities.
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References
Hočevar-Boltežar I. Fiziologija in patologija glasu ter izbrana poglavja iz patologije govora. Ljubljana: Littera picta; 2008.
Probst R, Grevers G, Iro H. Basic otorhinolaryngology. Stuttgart: Georg Thieme Verlag; 2006.
Young N, Wadie M, Sasaki CT. Neuromuscular basis for ventricular fold function. Ann Otol Rhinol Laryngol 2012; 121 Suppl 5: 317-21.
Monfared A, Gorti G, Kim D. Microsurgical anatomy of the laryngeal nerves as related to thyroid surgery. Laryngoscope 2002; 112 suppl 2: 386-92.
Sulica L, Blitzer A. Vocal fold paralysis. Heidelberg: Springer-Verlag Berlin Heidelberg; 2006.
Rubin A, Sataloff R. Vocal fold paresis and paralysis. Otolaryngol Clin N Am 2007; 40: 1109-31.
Furlan JC, Brandão LG, Ferraz AR. Prevalence of Galen's anastomosis: an anatomical and comparative study. J Laryngol Otol 2002; 116 Suppl 10: 823-5.
Vachha B, Cunnane M, Mallur P, Moonis G. Losing your voice: etiologies and imaging features of vocal fold paralysis. J Clin Imaging Sci 2013; 3: 15.
Zakaria H, Al Awad N, Al Kreedes A, Al-Mulhim A, Al-Sharway M, Maha Abdul H, et al. Recurrent laryngeal nerve injury in thyroid surgery. Oman Med J. 2011; 26 suppl 1: 34–8.
Rosenthal LH, Benninger MS, Deep RH. Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope 2007; 117 Suppl 10: 1864-70.
Rukholm G, Farrokhyar F, Reid D. Vocal cord paralysis post patent ductus arteriosus ligation surgery: risks and co-morbidities. Int J Pediatr Otorhinolaryngol 2012; 76: 1637-41.
Fauzdar S, Kraus J, Papageorge M. Vocal cord paralysis following orthognathic surgery intubation. Ann Maxillofac Surg 2011; 1 Suppl 2: 166–8.
Magnussen CR, Patanella HP. Herpes simplex virus and recurrent laryngeal nerve paralysis. Report of a case and review of the literature. Arch Intern Med 1979; 139 Suppl 12: 1423-4.
Habek M, Mubrin Z, Brinar VV. Avellis syndrome due to borreliosis. Eur J Neurol 2007; 14 Suppl 1: 112-4.
Berry H, Blair RL. Isolated vagus nerve palsy and vagal mononeuritis. Arch Otolaryngol 1980; 106 Suppl 6: 333-8.
Policeni BA, Smoker WR. Pathologic conditions of the lower cranial nerves IX, X, XI, and XII. Neuroimaging Clin N Am 2008; 18: 347–68.
El Mekkaoui A, Irhoudane H, Ibrahimi A, El Yousfi M. Dysphagia caused by a lateral medullary infarction syndrome (Wallenberg´s syndrome). Pan Afr Med J 2012; 12: 92.
Lee SI, Pyun SB, Jang DH. Dysphagia and hoarseness associated with painless aortic dissection: a rare case of cardiovocal syndrome. Dysphagia 2006; 21 Suppl 2: 129-32.
Singh PM, Borle A, Trikha A. Post-operative unmasked bilateral vocal cord palsy attributed to pre-operative radiotherapy. J Anaesthesiol Clin Pharmacol 2013; 29 Suppl 2: 272–4.
Farruggia P, Tropia S, Cannella S, Bruno G, Oddo G, D´Angelo P. Vocal cord palsy after vincristine treatment in a child and the inefficacy of glutamic acid in the prevention of relapse: a case report. J Med Case Rep 2012; 6: 128.
Chawla S, Wee D, Arora V. Adult chiari malformation presenting as bilateral vocal cord paralysis. Indian J Otolaryngol Head Neck Surg 2008; 60 Suppl 4: 382–3.
Brunner E, Friedrich G, Kiesler K, Chibidziura-Priesching J, Gugatschka M. Subjective breathing impairment in unilateral vocal cord paralysis. Folia Phoniatr Logop 2011; 63: 142-6.
Woodson GE. Configuration of the glottis in laryngeal paralysis. I: Clinical study. Laryngoscope 1993; 103 (11 Pt1): 1227-34.
Rickert SM, Childs LF, Carey BT, Murry T, Sulica L. Laryngeal electromyography for prognosis of vocal fold palsy: a meta-analysis. Laryngoscope 2012; 122 Suppl 1: 158-61.
Misono S, Merati AL. Evidence –based practice: evaluation and management of unilateral vocal fold paralysis. Otolaryngol Clin N Am 2012; 45: 1083-108.
Badia PI, Hillel AT, Shah MD, Johns MM 3rd, Klein AM. Computed tomography has low yield in the evaluation of idiopathic unilateral true vocal fold paresis. Laryngoscope 2013; 123 Suppl 1: 204-7.
Vats A, Worley GA, De Bruyn R, Porter H, Albert DM, Bailey CM. Laryngeal ultrasound to asses vocal fold paralysis in children. J Laryngol Otol 2004; 118: 429-31.
Hočevar Boltežar I. Nevrogeno pogojene motnje požiranja. In: Žargi M, Hočevar Boltežar I, Battelino S, ed. Otorinolaringološke dileme v ambulanti na osnovni ravni : izbrana poglavja 5; 2013; Ljubljana, Slovenija: Katedra za otorinolaringologijo Medicinske fakultete v Ljubljani, UKC LJ, Klinika za otorinolaringologijo in cervikofacialno kirurgijo, Združenje otorinolaringologov Slovenije SZD; 2013, p. 89-100.
Lichtenberger G. Endo-extralaryngeal needle carrier instrument. Laryngoscope 1983; 93: 1348-50.
Olthoff A, Zeiss D, Laskawi R, Kruse E, Steiner W. Laser microsurgical bilateral posterior cordectomy for the treatment of bilateral vocal fold paralysis. Ann Otol Rhinol Laryngol 2005; 114: 599-604.
Lagier A, Nicollas R, Sanjuan M, Benoit L, Triglia JM. Laser cordotomy for the treatment of bilateral vocal cord paralysis in infants. Int J Pediatr Otorhinolaryngol 2009; 73: 9-13.
Remacle M, Lawson G. Injectable substances for vocal fold augmentation. Curr Opin Otolaryngol Head Neck Surg 2001; 9: 393-7.
Remacle M, Lawson G. Results with collagen injection into the vocal folds for medialization. Curr Opin Otolaryngol Head Neck Surg 2007; 15: 148-52.
Gillespie MB, Dozier TS, Day TA, Martin-Harris B, Nguyen SA. Effectiveness of calcium apatit paste in vocal rehabilitation. Ann Otol Rhinol Laryngol 2009; 118: 546-51.
Mahieu H. Advances in laryngeal framework surgery. ENT News 2005; 14 Suppl 1: 48-51.
Bihari A, Mészáros K, Reményi A, Lichtenberger G. Voice quality improvement after management of unilateral vocal cord paralysis with different techniques. Eur Arch Otorhinolaryngol 2006; 263 Suppl 12: 1115-20.
Zeitels SM, Mauri M, Dailey SH. Medialization laryngoplasty with Gore-Tex for voice restoration secondary to glottal incompetence: indications and observations. Ann Otol Rhinol Laryngol 2003; 112 Suppl 2: 180-4.
Gardner GM, Altman JS, Balakrishnan G. Pediatric vocal fold medialization with silastic implant: intraoperative airway management. Int J Pediatr Otorhinolaryngol 2000; 52 Suppl 1: 37-44.
Smith ME, Roy N, Stoddard K. Ansa-RLN reinnervation for unilateral vocal fold paralysis in adolescents and young adults. Int J Pediatr Otorhinolaryngol 2008; 72: 1311-6.
Li Y, Pearce EC, Mainthia R, Athavale SM, Dang J, Ashmead DH, et al. Comparison of ventilation and voice outcomes between unilateral laryngeal pacing and unilateral cordotomy for the treatment of bilateral vocal fold paralysis. ORL J Otorhinolaryngol Relat Spec 2013; 75 Suppl 2: 68-73.
Mueller AH. Laryngeal pacing for bilateral vocal fold immobility. Curr Opin Otolaryngol Head Neck Surg 2011; 19 Suppl 6: 439 - 43.
Heavner SB, Rubin AD, Fung K, Old M, Hogikyan ND, Feldman EL. Dysfunction of the recurrent laryngeal nerve and the potential of gene therapy. Ann Otol Rhinol Laryngol 2007; 116 Suppl 6: 441-8.
Hočevar Boltežar I. Endoskopska kirurgija grla. In: Žargi M, Hočevar Boltežar I, Battelino S, ed. Otorinolaringološki problemi v vseh življenjskih obdobjih : izbrana poglavja 4; 2012; Ljubljana, Slovenija: Katedra za otorinolaringologijo Medicinske fakultete v Ljubljani, UKC Ljubljana, Klinika za otorinolaringologijo in cervikofacialno kirurgijo, Združenje otorinolaringologov Slovenije SZD; 2012, p. 51-7.
Kravos A, Jeličić M. Tireoplastika. In: Pahor D, Čizmarević B, ed. Zbornik predavanja in praktikum. Strokovni simpozij ob 90. Obletnici ustanovitve Oddelka za očesne, ušesne nosne in vratne bolezni UKC Maribor; 2009; Maribor, Slovenija: Univerzitetni klinični center; 2009, p. 168-72.
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