Role of Ultrasound in Analysis of Vocal Cord Movements in Comparison with Laryngoscopy

2019 ◽  
Vol 7 (2) ◽  
pp. 32-35
Author(s):  
Nagaraj Murthy ◽  
◽  
Dimple Bhatia ◽  
Keyword(s):  
Vocal Cord

DOZ047.98: The role of laryngeal electromyography in differential diagnosis of vocal cord immobility: a case report

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
A Salvati ◽  
M Trozzi ◽  
D Meucci ◽  
M L Tropiano ◽  
S Bottero
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Distress ◽  
Ct Scan ◽  
Vocal Cord ◽  
Pulmonary Function Tests ◽  
Brain Mri ◽  
Laryngeal Electromyography ◽  
Sleep Study ◽  
Neurological Evaluation

Abstract Object The term ‘vocal cord immobility’ (VCI) encompasses both vocal cord paralysis and crico-arytenoid joint ankylosis (CAJA). Bilateral VCI represents an emergency condition characterized by stridor and respiratory distress sometimes requiring tracheostomy to ensure an adequate and safe airway. The aim of this study is to describe the diagnostic and therapeutic management of a rare case of congenital bilateral CAJA in a patient without pregnancy complications, perinatal traumas, or other comorbidities. Materials and Methods The patient was born full term by C-section after a healthy pregnancy (BW 3270 g, APGAR 9 at 5'). After birth she presented severe stridor with respiratory distress. She was admitted to our hospital when she was 3 months old. The diagnostic assessment was performed with airway endoscopy, pulmonary function tests (PFT), sleep study, echocardiogram, neurological evaluation, chest computed tomography (CT) scan, and brain magnetic resonance imaging (MRI). Laryngeal electromyography (LEMG) with endoscopic placement of Hookwire electrodes was carried out for the differential diagnosis between paralysis and ankylosis and the subsequent choice of the treatment. PFT and sleep study were repeated after each endoscopic procedure. Results The first airway endoscopy showed bilateral VCI in paramedian position and palpatory evidence of bilateral crico-arytenoid joint fixation. PFT highlighted inspiratory obstruction at the flow/volume and flow/time curves and tidal volume reduction. Sleep study was indicative of mild–moderate obstructive apnea. Echocardiogram, neurological evaluation, brain MRI, and chest CT scan did not detect anomalies. LEMG showed continuous low-amplitude basal activity in all analyzed muscles, in the absence of spontaneous neurotonic activations. Motor evoked potentials (MEP) denoted normal left response and minimum right delay. Two glottic dilations were performed with 7 and 8 mm balloons determining the decrease of stridor and good respiratory balance confirmed by PFT. Endoscopy showed a slight recovery of laryngeal motility. Conclusion The management of this rare clinical case points out the crucial role of a careful and complete endoscopic examination including the palpation of the crico-arytenoid joints. Moreover LEMG represents an important instrument for the correct differential diagnosis in VCI. In the future the use of LEMG could be mandatory in pediatric patients in order to avoid tracheotomy in favor of more conservative procedures.

Role of Flexible Laryngoscopy in Evaluating Aspiration

1997 ◽  
Vol 106 (8) ◽  
pp. 705-709 ◽  
Author(s):  
Glenn M. Kaye ◽  
Richard D. Zorowitz ◽  
Soly Baredes
Keyword(s):  
Vocal Cord ◽  
Pharyngeal Residue ◽  
Flexible Laryngoscopy ◽  
Glottic Closure ◽  
Vocal Cord Mobility ◽  
Laryngeal Sensation ◽  
Gag Reflex ◽  
Highly Correlated ◽  
Risk Of Aspiration

Flexible fiberoptic laryngoscopy is used to evaluate dysphagia, but its clinical utility has not been compared to that of the videofluorographic swallowing study (VFSS). This study correlates parameters of both procedures and identifies laryngoscopy predictors of aspiration in 105 patients. Presence of aspiration, pharyngeal residue, laryngeal sensation, vocal cord mobility, and glottic closure during flexible laryngoscopy (FL), and gag reflex were correlated with aspiration during the VFSS. An algorithm for laryngoscopically detecting aspiration was synthesized. Aspiration (p = .004) and pharyngeal residue (p < .00001) were highly correlated between the two studies. Aspiration during the VFSS was correlated with pharyngeal residue (p < .00001) and laryngeal sensation (p = .027) during FL, but not glottic closure (p = .169) nor vocal cord mobility (p = .056). Patients with a normal gag reflex and without aspiration or pharyngeal residue during FL had a 2.94% risk of aspiration during the VFSS. Flexible laryngoscopy can be used as a relatively safe, portable screening test for aspiration, but cannot always replace the VFSS to identify the presence or cause of aspiration.

The Role of Ultrasonography in the Assessment of Vocal Cord Functions After Thyroidectomy

2017 ◽  
Vol 31 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Murat Ö. Kılıç ◽  
Serdar G. Terzioğlu ◽  
Serap Y. Gülçek ◽  
Engin Sarı
Keyword(s):  
Vocal Cord

Role of radiation in the management of early vocal cord carcinoma

1983 ◽  
Vol 9 (7) ◽  
pp. 997-1002 ◽  
Author(s):  
B. Mittal ◽  
D.V. Rao ◽  
J.E. Marks ◽  
C.A. Perez
Keyword(s):  
Vocal Cord

Congenital Bilateral Vocal Cord Paralysis and the Role of Glycine

2005 ◽  
Vol 114 (6) ◽  
pp. 494-498 ◽  
Author(s):  
Robert G. Berkowitz ◽  
Qi-Jian Sun ◽  
Paul M. Pilowsky
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Clinical Manifestations ◽  
Underlying Mechanism ◽  
Sprague Dawley ◽  
Bilateral Vocal Cord Paralysis ◽  
Sprague Dawley Rats ◽  
Motoneuron Activity ◽  
Made In

Objectives: We sought to modify normal laryngeal constrictor (LC) motoneuron activity to induce a pattern of aberrant LC muscle function that may serve as a model of congenital bilateral vocal cord paralysis. Methods: Single unit extracellular recordings of functionally identified LC motoneurons were made in anesthetized Sprague-Dawley rats, and the response to both intravenous and iontophoretic application of the glycine antagonist strychnine was studied. Results: The postinspiratory firing pattern of LC motoneurons became inspiratory after intravenous injection of strychnine (4 of 5 rats), but no change was recorded in response to strychnine iontophoresis (7 of 8 rats). Conclusions: Blockade of glycinergic inhibitory neurotransmission by strychnine, acting above the level of the LC motoneuron, causes LC motoneurons to fire during inspiration rather than after inspiration. This observation suggests that impaired glycine neurotransmission may be an underlying mechanism that explains the clinical manifestations of congenital bilateral vocal cord paralysis.

scholarly journals Study of laryngeal lesions undergoing microlaryngeal surgery in a tertiary health centre

2020 ◽  
Vol 6 (6) ◽  
pp. 1167
Author(s):  
Gangadhara K. S. ◽  
Chaitanya Vadva ◽  
Sridhara S.
Keyword(s):  
Vocal Cord ◽  
Health Centre ◽  
Cost Effective ◽  
Ratio Analysis ◽  
Good Tool ◽  
Laryngeal Lesions ◽  
Malignant Lesions ◽  
Microlaryngeal Surgery

<p class="abstract"><strong>Background:</strong> Patients with laryngeal lesions were evaluated for age and sex ratio, analysis of clinical features, videolaryngoscopic findings and histopathological features. Assessment of therapeutic role of microlaryngeal surgery (MLS) by telescopic method and also prognosis after surgery and voice therapy were evaluated.</p><p class="abstract"><strong>Methods:</strong> A prospective institutional based study. A total of 18 patients with vocal cord lesions the chief complaint being hoarseness of voice were subjected to surgery in a tertiary health centre. After thorough evaluation patients underwent MLS by telescopic method.  </p><p class="abstract"><strong>Results:</strong> In our study 6 patients stand out to be benign lesions and 12 patients stand out to be pre malignant and malignant lesions. Improvement in voice after surgery was reported in all patients. No recurrence was reported after 6-8 months of follow-up.</p><p class="abstract"><strong>Conclusions:</strong> MLS is a good tool as it is precise and cost effective. MLS by telescopic method is a good therapeutic tool in both benign and malignant vocal cord lesions.</p>

scholarly journals Role of Unilateral Vocal Cord Palsy in Causing Recurrent Tracheobronchial Foreign Bodies

2019 ◽  
Vol 7 ◽  
Author(s):  
Laurence Pincet ◽  
Karma Lambercy ◽  
Kishore Sandu
Keyword(s):  
Vocal Cord ◽  
Foreign Bodies ◽  
Vocal Cord Palsy

scholarly journals Role and mechanism of Glut-1 and H+/K+-ATPase expression in pepsin-induced development of vocal cord leukoplakia

2021 ◽  
Author(s):  
Yin-Jie Ao ◽  
Ting-Ting Wu ◽  
Zai-Zai Cao ◽  
Shui-Hong Zhou ◽  
Yang-Yang Bao ◽  
...  
Keyword(s):  
Gastric Juice ◽  
Vocal Cord ◽  
Laryngeal Carcinoma ◽  
G1 Phase ◽  
Dependent Manner ◽  
Glut 1 ◽  
Laryngeal Mucosa ◽  
M Phase ◽  
Artificial Gastric Juice

Abstract Purpose We investigated the role of Glut-1 and H+/K+-ATPase expression in pepsin-induced development of human vocal cord leukoplakia cells (HVCLCs). Next, we analyzed the relationship between Glut-1 and H+/K+-ATPase expression with the clinicopathological features of laryngeal carcinoma. Methods Glut-1 and H+/K+-ATPase expression levels in HVCLCs were determined after treatment with artificial gastric juice containing pepsin and laryngeal carcinoma tissues. Results Exposure to pepsin-containing artificial gastric juice significantly enhanced the migration and proliferation of VSCLCs in a time-dependent manner. The apoptotic rate of VSCLCs decreased over time after exposure to pepsin and reached a nadir on day 7 (p < 0.01). With increasing duration of exposure to pepsin, the proportion of VSCLCs in G0/G1 phase decreased and the proportions in the S and G2/M phases significantly increased (p < 0.05). After treatment with pepsin-containing artificial gastric juice, RT-PCR and Western blotting showed that the expression of Glut-1 and H+/K+-ATPase α, β significantly increased in HVCLCs compared to in the absence of pepsin (p < 0.05). The expression of Glut-1 and H+/K+-ATPase α, β gradually increased from vocal cord leukoplakia (VLC) to laryngeal carcinoma (p < 0.05). Lentivirus-mediated inhibition of Glut-1 expression in VCL significantly inhibited the cells’ migration and proliferation (p < 0.05) but enhanced their apoptosis (p < 0.05). Also, inhibition of Glut-1 expression resulted in an increased proportion of cells in G0/G1 phase and a significantly decreased proportion in G2/M phase (p < 0.05). Conclusions Elevated Glut-1 expression may promote the development of VCL by upregulating laryngeal H+/K+-ATPase expression to reactivate absorbed pepsin, thus damaging the laryngeal mucosa.

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