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Fold Paralysis (fold + paralysis)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of Fold Paralysis

vocal fold paralysis

Selected Abstracts

Injection Versus Medialization Laryngoplasty for the Treatment of Unilateral Vocal Fold Paralysis,

THE LARYNGOSCOPE, Issue 11 2007
Justin E. Morgan MD
Abstract Objective/Hypothesis: To determine whether injection laryngoplasty or medialization laryngoplasty is more effective in the treatment of unilateral vocal fold paralysis. Study Design: A retrospective study of patients with unilateral vocal fold paralysis who underwent either injection or medialization laryngoplasty at the University of Arkansas for Medical Sciences between July 29, 2003 and March 8, 2005. Methods: The data analyzed included patient characteristics and type of intervention, along with the pretreatment and posttreatment voice parameters of videostrobolaryngoscopy, perceptual analysis, and patients' subjective voice assessment. Results: Nineteen patients were evaluated. The average time from intervention to posttreatment evaluation was 3 (range, 1,9) months. Improvements were demonstrated in all three voice parameters in both the injection and the medialization groups. No significant differences were found in the degree of improvement between the two groups. Videostrobolaryngoscopy and the perceptual analysis, both rated by the authors, correlated well with each other, but they both correlated poorly with the patients' subjective voice analysis. Conclusions: Injection and medialization laryngoplasty were comparable in their improvement of subjective and objective voice outcomes. Both treatment modalities should be included in the otolaryngologist's armamentarium for managing unilateral vocal fold paralysis. [source]

Vocal Fold Paralysis After Anterior Cervical Spine Surgery: Incidence, Mechanism, and Prevention of Injury,

THE LARYNGOSCOPE, Issue 9 2000
Mark D. Kriskovich MD
Abstract Objective Vocal fold paralysis is the most common otolaryngological complication after anterior cervical spine surgery (ACSS). However, the frequency and etiology of this injury are not clearly defined. This study was performed to establish the incidence and mechanism of vocal fold paralysis in ACSS and to determine whether controlling for endotracheal tube/laryngeal wall interactions induced by the cervical retraction system could decrease the rate of paralysis. Study Design Retrospective review and complementary cadaver dissection. Methods Data gathered on 900 consecutive patients undergoing ACSS were reviewed for complications and procedural risk factors. After the first 250 cases an intervention consisting of monitoring of endotracheal tube cuff pressure and release of pressure after retractor placement or repositioning was employed. This allowed the endotracheal tube to re-center within the larynx. In addition, anterior approaches to the cervical spine were performed on fresh, intubated cadavers and studied with videofluoroscopy following retractor placement. Results Thirty cases of vocal fold paralysis consistent with recurrent laryngeal nerve injury were identified with three patients having permanent paralysis. With this technique temporary paralysis rates decreased from 6.4% to 1.69% (P = .0002). The cadaver studies confirmed that the retractor displaced the larynx against the shaft of the endotracheal tube with impingement on the vulnerable intralaryngeal segment of the recurrent laryngeal nerve. Conclusion The study results suggest that the most common cause of vocal fold paralysis after anterior cervical spine surgery is compression of the recurrent laryngeal nerve within the endolarynx. Endotracheal tube cuff pressure monitoring and release after retractor placement may prevent injury to the recurrent laryngeal nerve during anterior cervical spine surgery. [source]

Benign parathyroid cyst causing vocal fold paralysis: A case report and review of the literature

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2006
Daniel H. Coelho MD
Abstract Background. Parathyroid cysts are uncommon, frequently asymptomatic lesions of the neck and superior mediastinum. Symptomatic parathyroid cysts are very rare, with roughly only 200 cases reported in the literature. Of these, only nine cases have been reported with recurrent laryngeal nerve (RLN) paralysis Methods. We report a case of a 49-year-old man initially seen with a 6-month history of worsening hoarseness. Physical examination revealed a palpable 3-cm, firm, smooth, nontender mass of the right thyroid lobe. Fiberoscopic laryngoscopy showed right vocal cord immobility consistent with RLN paralysis. After CT and fine-needle aspiration of the mass, the patient underwent a right thyroid lobectomy. During surgery, the recurrent laryngeal nerve was found to be stretched and adherent to a right inferior lobe mass. Results. Histologic analysis of the surgical specimen revealed a benign parathyroid adenomatous cyst. Postoperatively, the patient's voice improved markedly. This case represents an extremely rare return of function of the RLN after cyst removal. Conclusion. Parathyroid cysts should be included in the differential diagnosis for vocal fold paralysis. © 2006 Wiley Periodicals, Inc. Head Neck 28:564,566, 2006 [source]

Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis,

THE LARYNGOSCOPE, Issue 9 2010
Follow-Up at Six Months
Abstract Objectives/Hypothesis: To determine whether injection laryngoplasty or medialization laryngoplasty is more effective in the long-term treatment of unilateral vocal fold paralysis (UVFP). Study Design: A retrospective study of patients with UFVP who underwent either injection or medialization laryngoplasty at the University of Arkansas for Medical Sciences between July 29, 2003 and November 18, 2005. Methods: The data analyzed included patient characteristics and type of intervention, along with the pretreatment and post-treatment parameters of videostrobolaryngoscopy, perceptual voice analysis, and patients' subjective assessment of voice handicap. Results: Thirty-four patients were evaluated, 15 new and 19 from a previous study. The average time from intervention to post-treatment evaluation in the new cohort was 4.8 months (range, 1.5,10.5 months). The average time from intervention to post-treatment in the combined cohort was 6.4 months (range, 1,24 months). Improvements were demonstrated in each of the measured voice parameters in both the injection and the medialization groups, and no significant differences were found in the degree of improvement between the two groups. Limited data on aerodynamic and acoustic voice measurements showed a trend toward improvement in each treatment group. Conclusions: Injection and medialization laryngoplasty were comparable in achieving voice improvement at the average long-term follow-up of 6 months. Laryngoscope, 2010 [source]

Three-dimensional arytenoid movement induced by vocal fold injections,

THE LARYNGOSCOPE, Issue 8 2010
Ted Mau MD
Abstract Objectives/Hypothesis: To quantitatively characterize arytenoid movement induced by vocal fold injection augmentation in an excised larynx model. Study Design: Laboratory and computational. Methods: Vocal folds of human cadaveric larynges were injected with calcium hydroxylapatite. High-resolution computed tomography scans were obtained before and after injection. Densities corresponding to the arytenoid and cricoid cartilages were extracted and processed with custom MATLAB routines to generate selective three-dimensional reconstructions of the larynx. Pre- and postinjection positions of the arytenoid were compared. Results: Vocal fold injections resulted in predominantly small-magnitude medial rotation and medial translation of the arytenoid. Movements in other directions as would be expected in physiologic adduction were not observed. Conclusions: Vocal fold injection augmentation induced passive movement of the arytenoid that has not been described previously. This movement does not reproduce the trajectory of physiologic adduction. This finding has implications for the treatment of unilateral vocal fold paralysis without arytenoid repositioning maneuvers. Laryngoscope, 2010 [source]

Optimization of Autologous Muscle Stem Cell Survival in the Denervated Hemilarynx,

THE LARYNGOSCOPE, Issue 7 2008
Stacey L. Halum MD
Abstract Objective: Current treatments for vocal fold paralysis are suboptimal in that they fail to restore dynamic function. Autologous muscle stem cell (MSC) therapy is a promising potential therapy for vocal fold paralysis in that it can attenuate denervation-induced muscle atrophy and provide a vehicle for delivery of neurotrophic factors, thereby potentially selectively guiding reinnervation. The goal of this project was to characterize optimal conditions for injected autologous MSC survival in the thyroarytenoid (TA) muscle following recurrent laryngeal nerve (RLN) injury by local administration of adjuvant factors. Study Design: Animal experiment. Methods: Unilateral RLN transection and sternocleidomastoid muscle (,1 g) biopsies were performed in 20 male Wistar rats. One month later, 106 autologous MSCs labeled via retroviral-enhanced green fluorescent protein (EGFP) transduction were injected into the denervated hemilarynx of each animal with one of four adjuvant therapies: cardiotoxin [(CTX) 10,5 M], insulin-like growth factor-1 [(IGF- 1) 100 ,g/mL], ciliary neurotrophic factor [(CNTF) 50 ,g/mL], or saline. Animals were euthanized 1 month later and larynges harvested, sectioned, and analyzed for MSC survival. Results: All specimens demonstrate extensive MSC survival, with fusion of the MSCs with the denervated myofibers. Based on mean fluorescent intensity of the laryngeal specimens, IGF-1 and CNTF had the greatest positive influence on MSC survival. Myofiber diameters demonstrated myofiber atrophy to be inversely related to MSC survival, with the least atrophy in the groups having the greatest MSC survival. Conclusions: Autologous MSC therapy may be a future treatment for vocal fold paralysis. These findings support a model whereby MSCs genetically engineered to secrete CNTF and/or IGF-1 may not only promote neural regeneration, but also enhance MSC survival in an autocrine fashion. [source]

Injection Versus Medialization Laryngoplasty for the Treatment of Unilateral Vocal Fold Paralysis,

War, Politics, and Voice: The Vocal Fold Paralysis of George Orwell,

THE LARYNGOSCOPE, Issue 2 2007
Lucian Sulica MD
Abstract Background: In 1936, like many individuals who felt the menace of fascism, George Orwell traveled to Spain to lend his support to the cause of the Republic, battling a right-wing coup. Spain, during its Civil War, was an eye-opening experience for him, yielding insights that allowed, and even compelled him to write Animal Farm and 1984. Spain was also a close brush with death. In May of 1937, in a trench on a windswept ridge near Huesca, Orwell was shot through the neck by a sniper, leaving him with a paralyzed vocal fold. Design: A thorough review of firsthand accounts of Orwell's injury and subsequent care was made. These are presented in the context of current knowledge of ballistics, penetrating neck trauma, and vocal fold paralysis. Results and Conclusion: Orwell survived largely because of the nature of his wounding with a high-velocity jacketed military round. His recovery followed a course in many ways typical for patients with vocal fold paralysis. His writings leave us a unique and extraordinary account of the experience of being shot, of the medical care of the day, of the handicap of paralytic dysphonia, and of survival and heroism under extraordinary circumstances. [source]