1/9. Acute laryngeal paralysis induced by the migration of a totally implantable venous access device's catheter tip.The authors report a case of acute vagus nerve paralysis that appeared during a course of chemotherapy. The drugs had been administered through a totally implantable venous access device (TIVAD), whose catheter tip had migrated into the right internal jugular vein (IJV) and was surrounded by a complete venous thrombosis. The supposed aetiology of this paralysis was a leakage of the cytotoxic drug (5-fluorouracil) from the vessel wall into the surrounding carotid space, because of the stagnation of the chemotherapeutic agent above the thrombosis. Four months after cessation of chemotherapy, the laryngeal paralysis was still evident.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Complete extirpation of a bronchogenic cyst causing recurrent laryngeal nerve palsy by thoracoscopy: report of a case.We excised a bronchogenic cyst causing recurrent laryngeal nerve palsy using thoracoscopic surgery. A 28-year-old woman presented after the sudden onset of hoarseness, and laryngoscopic examination showed left vocal cord palsy. Computed tomography and magnetic resonance imaging showed a cystic mass, 4 cm in diameter, in the aortopulmonary window. Thoracoscopic examination revealed that the mass was adhered to the recurrent laryngeal nerve below the aortic arch. We extirpated the cyst via thoracoscopy without any injury to the nerves or major blood vessels. This case illustrates the benefits of thoracoscopic surgery for providing good visualization of the perineural structures and as a safe surgical treatment for a cystic mass in the aortopulmonary window.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/9. A variant form of nasogastric tube syndrome.Nasogastric tube syndrome named by Sofferman et al in 1981 is a laryngeal complication presenting with life-threatening vocal cord abductor paralysis derived from peroforation of the NG tube-induced esophageal ulcer. As compared with the previously reported cases of this syndrome, our 4 autopsied patients were so peculiar in the following two points that vocal cord abductor paralysis developed repeatedly and no esophageal ulcer was present in spite of the presence of the laryngeal abductor muscle injury. We hypothesized that the etiology of such a variant form was circulatory injury of the laryngeal abductor muscle which was caused by the compression of the postcricoid blood vessels perfusing this muscle. Nasogastric tube syndrome, which is treatable by decannulation, cannot be ruled out even if no esophageal ulcer is detected by fiberoptic laryngoscopy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. vocal cord paralysis with Ebstein's anomaly.Left 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.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/9. vocal cord paralysis associated with cystic fibrosis.The course of the left recurrent laryngeal nerve through the chest brings it in close proximity with the heart and great cardiac vessels. Diseases of the heart and the great vessels are known to cause vocal cord paralysis, probably by mechanical injury to the recurrent laryngeal nerve. pulmonary artery hypertension and dilation occur in up to 80% of patients with cystic fibrosis. We report a case of a 23-year-old woman with cystic fibrosis and left vocal cord paralysis. We believe that sudden pulmonary artery expansion produced recurrent laryngeal nerve injury and vocal cord paralysis. This is only the second association of unilateral vocal cord paralysis and cystic fibrosis in the medical literature. The pathophysiology of the cardiovocal syndrome is discussed.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
6/9. vocal cord paralysis. association with superior mediastinal widening secondary to tortuosity of the great vessels.A 60-year-old man had left vocal cord paralysis and a superior mediastinal mass. Rather than the expected mediastinal tumor involving the recurrent laryngeal nerve, he was found to have tortuosity of the great vessels of the neck that caused the mediastinal widening. In all likelihood, this was unrelated to the vocal cord paralysis. The diagnosis was suspected and invasive studies avoided due to close scrutiny of the lateral chest roentgenogram.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
7/9. Superior laryngeal nerve paralysis and benign thyroid disease.A case of an isolated superior laryngeal nerve paralysis from a thyroid adenoma is presented. Superior laryngeal nerve paralyses should be sought, particularly in the preoperative and postoperative examination of thyroidectomy patients. Symptoms of a change in vocal strength or pitch and aspiration along with the laryngoscopic findings of a glottis posteriorly rotated toward a bowed vocal cord are diagnostic. Surgical trauma to the superior laryngeal nerve, though a risk of any thyroidectomy, usually can be avoided if one knows its possible anatomic variations and meticulously dissects the superior thyroid pole and its vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/9. Clinically probable brainstem stroke presenting primarily as dysphagia and nonvisualized by MRI.Ten patients with clinically probable brainstem stroke presenting primarily as acute dysphagia but without visible brainstem abnormality by MRI are described. The patients were evaluated with neurologic examinations, cinepharyngoesophagography, and brain MRI studies. Each patient solely or predominately experienced sudden pharyngeal dysphagia, and additional symptoms or signs other than dysphonia or dysarthria were scarce. Small vessel disease or cardiac embolism were the apparent causes of what appear to have been very discrete brainstem strokes in these patients. Acute pharyngeal dysphagia can be the sole or primary manifestation of brainstem stroke. A negative MRI study should not preclude consideration of this diagnosis, if brainstem stroke is otherwise clinically probable.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/9. Laryngeal schwannomas.As laryngeal schwannomas are a threat to breathing, they must be removed. CT and MR provide an accurate pre-operative work-up of these lesions. The clear delineation of the tumoral attachment to the larynx proved to be very useful in the difficult management of our second patient. Our two laryngeal schwannomas exhibited a similar appearance which differed from those of the few other laryngeal nerve sheath tumors reported in the literature The low attenuating outer part correlated with Antoni B areas. The denser enhancing inner part correlated with Antoni A areas containing large vessels. This unusual tumoral appearance, which has been observed in some other peripheral schwannomas, must bring this diagnostic possibility to mind. However, this clearly contrasting distribution of the two components of schwannomas is not the most commonly observed in other locations. More reports are needed to establish whether this special appearance is characteristic of laryngeal location.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |