Recurrent Laryngeal Nerve Paralysis during Transvenous Insertion of a Permanent Endocardial Pacemaker

1993 ◽  
Vol 102 (10) ◽  
pp. 810-813 ◽  
Author(s):  
Yuval Zohar ◽  
Nora Buller ◽  
Ytzhak Shvilly
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Medical Intervention ◽  
Sudden Onset ◽  
Laryngeal Nerve ◽  
Unusual Complication ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Lesion ◽  
Nerve Paralysis ◽  
Unilateral Vocal Cord Paralysis

We present 2 patients with sudden onset of dysphonia due to acute unilateral vocal cord paralysis that occurred during transvenous insertion of a permanent endocardial pacemaker. Acute paralysis of the vocal cord due to this kind of medical intervention is a very unusual complication that has been rarely reported. We believe that traumatic insertion of a pacemaker through the subclavian vein triggered a dynamic process that led to vocal cord paralysis. Three hypothetic explanations are presented: 1) a direct vagus nerve lesion, 2) a direct inferior laryngeal nerve lesion, and 3) a central nervous system lesion caused by a cerebral microembolus. Physicians should be aware of the possibility that associated acute paralysis of the vocal cord may occur after transvenous insertion of an endocardial pacemaker.

PS01.189: A STUDY ON THE UTILITY OF INTRAOPERATIVE NEUROSTIMULATION MONITORING SYSTEM FOR RECURRENT LARYNGEAL NERVE IN ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 103-103
Author(s):  
Fumiaki Kawano ◽  
Shinsuke Takeno ◽  
Kousei Tashiro ◽  
Rouko Hamada ◽  
Yasuyuki Miyazaki ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Postoperative Management ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Recurrent Nerve ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Stimulation Of

Abstract Background Recurrent laryngeal nerve paralysis in esophagectomy is one of the most concerned complications. In recent years, intraoperative neurostimulation monitoring system (IONM) in thyroid surgery have been widespread for identification of recurrent laryngeal nerve and assessment of soundness. Therefore, IONM is often used during esophagectomy in Japan. In this study, we examined the efficacy of IONM in the patients undergoing esophagectomy. Methods Of 66 patients underwent esophagectomy since April 2015 until December 2017, IONM used in 27 patients in the surgery for the examination of recurrent nerve paralysis. We retrospectively reviewed these cases for intraoperative findings, neurostimulation monitoring findings and their outcomes. Results Of 27 patients, 25 were male and two were female, and the median age at operation was 66 years old. Although IONM was used in cervical lymph node dissection, there were no vocal cord responses in 5 patients (left side in 4 and right side in 1) with stimulation of the vagus nerve. Because all patients had no vocal cord paralysis due to stimulation of the cervical recurrent laryngeal nerve, it was diagnosed that there was the recurrent laryngeal nerve injury due to thoracic para recurrent nerve lymph node dissection. IONM was able to facilitate the identification and preservation of cervical recurrent nerve in all patients. Three out of 5 patients with no vocal cord response by IONM were confirmed recurrent laryngeal nerve paralysis in postoperative endoscope. In patients with vocal cord paralysis by IONM, it was possible to carefully performed postoperative management. On the other hand, in patients without paralysis, extubation on the operation day seemed possible without the concern for aspiration. Conclusion By using IONM in esophagectomy, we were able to evaluate the damage of the recurrent laryngeal nerve in real-time. Confirming the intraoperative recurrent nerve injuries is important for postoperative management or prediction of postoperative aspiration pneumonia. IONM in esophagectomy was useful not only in terms of surgical procedures but also in the evaluation of postoperative management. Disclosure All authors have declared no conflicts of interest.

Vocal cord paralysis with Ebstein's anomaly

1989 ◽  
Vol 103 (6) ◽  
pp. 626-628 ◽  
Author(s):  
S. N. Krishnamurthy ◽  
K. O. Paulose
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Laryngeal Nerve ◽  
Ebstein’S Anomaly ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Paralysis ◽  
Ebstein's Anomaly ◽  
Close Relationship ◽  
Left Recurrent Laryngeal Nerve

AbstractLeft recurrent laryngeal nerve runs a long intrathoracic course in close relationship to the aortic arch and adjacent heart structures and, hence, is liable to be injured by diseases affecting the heart and its great vessels.We report a case of Ebstein's anomaly causing left recurrent laryngeal nerve paralysis in a neonate. To our knowledge, this is the first reported case of vocal cord paralysis associated with this condition.

Neonatal Vocal Cord Paralysis Following Extracorporeal Membrane Oxygenation

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 793-796 ◽  
Author(s):  
Robert E. Schumacher ◽  
Irvin J. Weinfeld ◽  
Robert H. Bartlett
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Membrane Oxygenation ◽  
The Right ◽  
Unilateral Vocal Cord Paralysis

Five cases of unilateral vocal cord paralysis/ paresis were diagnosed following extracorporeal membrane oxygenation for newborn respiratory failure. All were right sided and transient in nature. None of the five patients had other findings commonly associated with vocal cord palsy. The extracorporeal membrane oxygenation procedure requires surgical dissection in the carotid sheath on the right side of the neck, an area immediately adjacent to both the vagus and recurrent laryngeal nerve. It is speculated that vocal cord paralysis in these infants was acquired as a result of the extracorporeal membrane oxygenation cannulation. Although the vocal cord paralysis resolved in all cases, two patients had difficult courses after extracorporeal membrane oxygenation. Therefore, laryngoscopic examination should be considered for patients after extracorporeal membrane oxygenation.

scholarly journals Unilateral Vocal Cord Paralysis Case Related to COVID-19

2021 ◽  
Author(s):  
Müge Özçelik Korkmaz ◽  
Mehmet Güven
Keyword(s):  
Vocal Cord ◽  
Peripheral Nerves ◽  
Vocal Cord Paralysis ◽  
Laryngeal Nerve ◽  
Voice Therapy ◽  
Neurologic Disease ◽  
Vascular Risk ◽  
Voice Changes ◽  
History Of ◽  
Unilateral Vocal Cord Paralysis

Abstract Introduction: Although the most common neuro-otolaryngological findings associated with COVID-19 infection are chemosensory changes, it should be known that these patients may present with different clinical findings.Case summary: We present a 57-year-old woman who developed progressive hoarseness while suffering from COVID-19 infection without a history of chronic disease or any other etiological cause. Laryngeal fiberscopy revealed left vocal cord fixed at the cadaveric position and there was 5-6 mm intraglottic gap during phonation. No other etiological cause was found in the examinations performed with detailed ear nose throat examination, neurological evaluations and imaging methods. Injection laryngoplasty was applied to the patient, and voice therapy was initiated, resulting in significant improvement in voice quality.Discussion: The mechanism of the idiopatic vocal cord paralysis remains unclear, it is suspected to be related to COVID-19 neuropathy, because the patient had no preexisting vascular risk factors or evidence of other neurologic disease on neuroimaging. Laryngeal nerve palsies may represent part of the neurologic spectrum of COVID-19.Conclusion: The possibility of the peripheral nerves damage caused by SARS-CoV-2, vocal cord paralysis should be considered when voice changes occur during COVID 19 infection.

scholarly journals The quality of voice and speech before and after surgical treatment of bilateral recurrent laryngeal nerve paralysis

2017 ◽  
Vol 70 (5-6) ◽  
pp. 146-149
Author(s):  
Maja Bogdan ◽  
Rajko Jovic ◽  
Tanja Arbutina
Keyword(s):  
Surgical Treatment ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Bilateral Vocal Cord Paralysis ◽  
Nerve Paralysis ◽  
Quality Of Voice ◽  
Voice And Speech

Introduction. Bilateral recurrent laryngeal nerve paralysis usually occurs after thyroid surgery. In bilateral vocal cord paralysis, the voice is clear or slightly hoarse. The aim of this study was to determine whether the quality of voice and speech significantly deteriorates after the surgical treatment of bilateral recurrent laryngeal nerve paralysis. Material and Methods. The study included 16 patients with bilateral vocal cord paralysis and 16 age- and sex-matched healthy controls. The patients underwent partial arytenoidectomy with posterior cordectomy at the Clinical Center of Vojvodina in the period from January to April 2014. The quality of voice and speech was determined before and after surgical treatment by subjective, objective, aerodynamic voice analysis, and analysis of spontaneous speech, and then compared to the control group. Results. The results of this study showed that in patients with bilateral vocal cord paralysis the voice and speech quality was significantly worse compared to the healthy subjects. The results of subjective and aerodynamic analysis showed that there was a statistically significant deterioration in voice quality after the surgical treatment (p<0.05; p=0.001). The values of objective analysis and analysis of spontaneous speech parameters did not significantly change after the surgery (p>0.05; p=0.401). Conclusion. The patients with bilateral vocal cord paralysis have a poorer voice and speech quality compared to the healthy subjects. After the surgical treatment, patients presented with a lower voice quality, but there were no significant changes regarding the ability of spontaneous speech.

A Sudden Onset of High-Pitched Voice Associated with Unilateral Vocal Cord Paralysis: A Case Report

1974 ◽  
Vol 39 (3) ◽  
pp. 373-375 ◽  
Author(s):  
Ehud Yairi
Keyword(s):  
Case Report ◽  
Vocal Cord ◽  
Case History ◽  
Vocal Cord Paralysis ◽  
Sudden Onset ◽  
Therapeutic Procedures ◽  
History Of ◽  
Unilateral Vocal Cord Paralysis

A case history of a patient with an acquired high-pitched voice is presented, emphasizing unusual history and symptoms. Successful remediation was accomplished through traditional therapeutic procedures.

Functional Electrical Stimulation for the Treatment of Bilaterial Recurrent Laryngeal Nerve Paralysis

1986 ◽  
Vol 95 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Randal A. Otto ◽  
William Davis
Keyword(s):  
Electrical Stimulation ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Functional Electrical Stimulation ◽  
Intrathoracic Pressure ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis ◽  
Trigger Stimulus

We have previously presented the concept of electrophysiologic pacing of bilaterally paralyzed vocal cord abductors as a solution to the difficult problem incurred in this clinical situation. Initially, we demonstrated that it was indeed feasible to electrophysiologically pace abduction of the vocal cords synchronously with respiration, employing the EMG activity of the diaphragm as a trigger stimulus. Further research has led us to evaluate other possible physiologic trigger stimuli to ascertain which of these will prove most suitable in long-term pacing studies. In this article, we will report our preliminary results, employing negative intrathoracic pressure occurring with respiration—as detected by an implanted pressure transducer as a trigger stimulus. This device was interfaced with a muscle stimulator attached to electrodes placed in the cricoarytenoid muscles in five canines whose recurrent laryngeal nerves had been sectioned bilaterally. In all animals, obvious physiologic synchrony of vocal cord abduction and a reduciton of negative inspiratory intratracheal pressure was achieved during electrical pacing. This reinforces our initial findings that it is indeed feasible to pace vocal cord abduction in bilaterial recurrent laryngeal nerve paralysis with resultant return of physiologic normality to the glottis. Thus, functional electrical stimulation offers an alternative approach to the difficult problems incurred in the patient with bilateral recurrent laryngeal nerve paralysis. It also demonstrates that physiologic negative intrathoracic pressure activity occurring with inspiration can be a trigger source.

Electrophysiologic pacing of vocal cord abductors in bilateral recurrent laryngeal nerve paralysis

1985 ◽  
Vol 150 (4) ◽  
pp. 447-451 ◽  
Author(s):  
Randal A. Otto ◽  
William Davis ◽  
J.Robert Betten ◽  
Phillip Downen ◽  
Pamela M. Otto
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Nerve Paralysis ◽  
Laryngeal Nerve Paralysis
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