scholarly journals Recurrent Nerve Palsy due to a Giant Vertebral Artery Aneurysm

2018 ◽  
Vol 10 (3) ◽  
pp. 266-271
Author(s):  
Pushpa Raj Puri ◽  
Michael Anders Petersen

Vertebral artery aneurysms are rare and challenging as they are usually asymptomatic and, therefore, often overlooked. We report the case of a 73-year-old man with a history of progressive dysphagia for 1 year. Computed tomography (CT) and computed tomography with angiography (CTA) of the cerebrum revealed a giant vertebral artery aneurysm compressing the medulla. Fiberoptic endoscopic evaluation of swallowing (FEES) revealed recurrent nerve paralysis. The patient was managed conservatively since the aneurysm was completely thrombosed.

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Takeshi Kusunoki ◽  
Hirotomo Homma ◽  
Yoshinobu Kidokoro ◽  
Akihisa Yoshikawa ◽  
Kumiko Tanaka ◽  
...  

We experienced a case of huge chronic thyroiditis with malignant lymphoma that caused dyspnea with tracheal stenosis, dysphagia with esophagus stenosis and recurrent nerve paralysis. In this case, thyroidectomy was performed and, after the surgery, there was no sign of breathing or swallowing difficulties, and it was confirmed by the postoperative computed tomography that the tracheal stenosis had improved. We considered two possible explanations for the preoperative right recurrent nerve paralysis. In the first, the right recurrent nerve could have suffered from mechanical stimulation such as compression and traction to the recurrent nerve due to enlargement of the malignant lymphoma together with chronic thyroiditis. The second possible explanation was that malignant cells had invaded neurons. We could not distinguish between the two possibilities, since this right recurrent nerve was spared and could not be examined histopathologically.


2015 ◽  
Vol 66 (6) ◽  
pp. 385-390 ◽  
Author(s):  
Makoto Miyamoto ◽  
Tomofumi Sakagami ◽  
Masao Yagi ◽  
Eri Miyata ◽  
Koichi Tomoda ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Qiang Lu ◽  
Shu-Qin Xie ◽  
Si-Yuan Chen ◽  
Li-Ju Chen ◽  
Qian Qin

Background. Although the procedure requires a small surgical incision and a short duration, incision infection rate is very low in thyroidectomy; however, doctors still have misgivings about infection events.Aim. We retrospectively analyzed the prevention of incision infection without perioperative use of antibacterial medications following thyroidectomy.Materials and Methods. 1166 patients of thyroidectomy were not administered perioperative antibiotics. Unilateral total lobectomy or partial thyroidectomy was performed in 68.0% patients with single-side nodular goiter or thyroid adenoma. Bilateral partial thyroidectomy was performed in 25.5% patients with nodular goiter or Graves’ disease. The mean time of operation was 80.6 ± 4.87 (range: 25–390) min.Results.Resuturing was performed in two patients of secondary hemorrhage from residual thyroid following bilateral partial thyroidectomy. Temporally recurrent nerve paralysis was reported following right-side total lobectomy and left-side subtotal lobectomy in a nodular goiter patient. One case had suppurative infection in neck incision 5 days after bilateral partial thyroidectomy.Conclusions. Thyroidectomy, which is a clean incision, involves a small incision, short duration, and minor hemorrhage. If the operation is performed under strict conditions of sterility and hemostasis, antibacterial medications may not be required to prevent incision infection, which reduces cost and discourages the excessive use of antibiotics.


2015 ◽  
Author(s):  
Mike-Ely Cohen ◽  
Muriel Lefort ◽  
Héloïse Bergeret-Cassagne ◽  
Siham Hachi ◽  
Ang Li ◽  
...  

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 99-99
Author(s):  
Yuki Hirata ◽  
Hirofumi Kawakubo ◽  
Shuhei Mayanagi ◽  
Kazumasa Fukuda ◽  
Rieko Nakamura ◽  
...  

Abstract Background In our institute, we usually use gastric tube for reconstruction organ after esophagectomy. When we can’t use gastric tube, we use right hemi-colon with ante-thoracic route. Previously, we reconstructed by 1-step after esophagectomy, but from 2012, we have done by 2-step for reduce postoperative complications. Methods We enrolled 15 esophageal cancer patients who underwent esophagectomy and right hemicolon reconstruction between April 2004 and December 2016. Results The average age of 15 patients is 67.3. The reasons of using right hemicolon are as follows; post gastrectomy 13, stomach double cancer 2. The reasons of gastrectomy are as follows; gastric cancer 8, duodenum cancer 1, gastric ulcer 4. The average duration from gastrectomy to esophagectomy is 12.5 year. We reconstructed by 1-step for 5 patients, and after 2012, we reconstructed by 2-step for 10 patients. Anastomotic leakages were found in 2 cases (40.0%) in 1-step reconstruction group, and 3 cases (20.0%) in 2-step reconstruction group. In 1-step reconstruction group, 1 case occurred multiple anastomotic leakages and DIC, and another 1 case was found necrosis of reconstructive colon. In 2-step reconstruction group, we found 1 case of major leakage and 1 case of recurrent nerve paralysis and 2 cases of postoperative pneumonia. However, there were no case of tracheotomy. The incidence of pneumonia did not differ between the two groups. And the term of postoperative oral intake tend to shorter in 2-step reconstruction group (P = 0.06). 2 severe postoperative complications (Clavian-Dindo V or IVa) cases were found in 1-step reconstruction group, on the other hand, 2 cases severe complications (CD IIIa) in 2-step reconstruction group. Conclusion In the case of using right hemicolon as a reconstructive organ, 2-step reconstruction approach is useful and superior from the viewpoints of postoperative complications. Disclosure All authors have declared no conflicts of interest.


1999 ◽  
Vol 256 (S1) ◽  
pp. S47-S50 ◽  
Author(s):  
H. Miyazaki ◽  
H. Yamashita ◽  
T. Masuda ◽  
T. Yamamoto ◽  
S. Komiyama

2011 ◽  
Vol 60 (1) ◽  
pp. 101-104
Author(s):  
Kenta Momii ◽  
Kazutoshi Nakaie ◽  
Jyunya Ogata ◽  
Shinichi Fukumoto ◽  
Ryuichi Taen

1976 ◽  
Vol 85 (4) ◽  
pp. 451-459 ◽  
Author(s):  
Herbert H. Dedo

Spastic dysphonia is a severe vocal disability in which a person speaks with excessively adducted vocal cords. The resulting weak phonation sounds tight, as if he were being strangled, and has also been described as laryngeal stutter. It is often accompanied by face and neck grimaces. In the past it has been regarded as psychoneurotic in origin and treated with speech therapy and psychotherapy with disappointing results. Because of laboratory and clinical observation that recurrent nerve paralysis retracts the involved vocal cord from the midline, it was proposed that deliberate section of the recurrent nerve would improve the vocal quality of patients with spastic dysphonia. In 34 patients the recurrent nerve was sectioned after Xylocaine® temporary paralysis showed significant improvement in vocal quality. Several patients have been advised against this operation because of the type of voice they developed with one vocal cord temporarily paralyzed. With nerve section plus postoperative speech therapy, approximately half of the patients have returned close to a “normal” but soft phonatory voice. The rest had varying degrees of improvement, but all, so far, have been pleased with the improvement in ease and quality of phonation and reduction or elimination of face and neck grimaces. Two men have a breathy component in their phonatory voices, and one woman has variable pitch.


1999 ◽  
Vol 106 (4) ◽  
pp. 2247-2247
Author(s):  
Noriko Kobayashi ◽  
Hajime Hirose ◽  
Kenji Matsui ◽  
Noriyo Hara

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Lampis C. Stavrinou ◽  
George Stranjalis ◽  
Pantelis C. Stavrinou ◽  
N. Bontozoglou ◽  
Damianos E. Sakas

Background. Aneurysms of the extracranial vertebral artery are rare and can provide a diagnostic and therapeutic challenge.Methods. We reviewed the clinical history of a patient presenting with cervical radiculopathy, who harboured an extracranial vertebral artery aneurysm eroding the cervical spine.Results. CT Angiography and MR Angiography set the diagnosis, by revealing a left C5-C6 vertebral artery aneurysm with cervical root impingement. Bony reconstruction depicted enlargement of the C6 transverse foramen and a marked enlargement of the C6-C7 intravertebral foramen. The lesion was treated by intravascular proximal vertebral artery occlusion.Conclusions. Extracranial vertebral artery aneurysms require a high index of clinical suspicion. This is the first report of a vertebral artery pseudoaneurysm presenting with bony erosion, which supports a less minacious portrayal of vertebral artery aneurysms.


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