The following are the most important diseases or complications that may be contributed to by recurrent paresis (vocal cord paralysis): Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99). Dyspnea (shortness of breath) Hoarseness (dysphonia)
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Auscultation (listening) to the lungs [due tosymptom: dyspnea (shortness of breath)]. ENT medical examination – including laryngoscopy (laryngoscopy). Neurological … Vocal Cord Paralysis (Recurrent Paresis): Examination
Laboratory diagnosis is usually not required.
Medical history (history of illness) represents an important component in the diagnosis of recurrent paresis (vocal cord paralysis). Family history Social anamnesis Current anamnesis/systemic anamnesis (somatic and psychological complaints). What symptoms have you noticed? Do you suffer from hoarseness? Do you have shortness of breath? Vegetative anamnesis including nutritional anamnesis. Have you lost weight recently? … Vocal Cord Paralysis (Recurrent Paresis): Medical History
General Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99) Voice disorders, unspecified Arthrogenic paralysis – paralysis originating from the joint Respiratory system (J00-J99) Long-standing recurrent paresis Musculoskeletal system and connective tissue (M00-M99). Chronic polyarthritis More After long-term intubation After radiatio (radiotherapy) Myogenic paralysis – due to damage to the muscles of the … Vocal Cord Paralysis (Recurrent Paresis): Or something else? Differential Diagnosis
Obligatory medical device diagnostics. Laryngoscopy (laryngoscopy). Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification. Echolaryngography (ultrasound examination of the larynx including assessment of vocal folds and pocket folds). X-ray of the thorax (X-ray thorax/chest), in two planes. … Vocal Cord Paralysis (Recurrent Paresis): Diagnostic Tests
Unilateral recurrent paresis Medialization thyroplasty (thyroplasty) In thyroplasty, a cartilage/silicone wedge is inserted at the larynx through a skin incision (phonochirugy). Type I thyroplasty (according to Isshiki) results in static, permanent medialization of the vocal fold by paraglottic (“located next to the glottis”) insertion of an implant. Indications (areas of application): Paralysis of the larynx … Vocal Cord Paralysis (Recurrent Paresis): Surgical Therapy
The following symptoms and complaints may indicate recurrent paresis (vocal cord paralysis): Unilateral recurrent paresis Mild hoarseness Singing is not possible Voice fatigue Attenuated cough thrust Bilateral recurrent paresis Low hoarseness Severe dyspnea (shortness of breath) Inspiratory stridor – whistling breathing sound on inspiration (typical of narrowing or obstruction of the upper airway (larynx, trachea, … Vocal Cord Paralysis (Recurrent Paresis): Symptoms, Complaints, Signs
Pathogenesis (development of disease) The recurrent laryngeal nerve is a branch of the vagus nerve. The laryngeus recurrens nerve dextra (right) runs its course around the subclavian artery (subclavian artery), then along the trachea (windpipe) and behind the thyroid gland to the larynx. The larygeus recurrens sinister nerve (left) loops around the aortic arch in … Vocal Cord Paralysis (Recurrent Paresis): Causes
Further measures: Vocal exercises Electrotherapy Thyroplasty, if necessary: in this procedure, a cartilage window is excised through a small skin incision above the thyroid cartilage and an implant (e.g., titanium implant) is inserted, medializing the vocal fold (i.e., shifting an anatomical structure medially, toward the center of the body).
