Etiology
- Cervical malignancy: encroachment on recurent laryngeal nerve (usually left)
- Mediastinal mass: encroachment on recurrent laryngeal nerve (usually left)
- Aortic aneurysm: encroachment on recurrent laryngeal nerve (usually left)
- Post-intubation: may cause cricoarytenoid fixation, glottic web, interstitial fibrosis (all simulate paralysis of cord)
- Idiopathic unilateral vocal cord paralysis:
Physiology
- Paralyzed cord is near midline
Diagnosis
- ABG: PFT’s: usually normal
- FOB: reveals paralyzed cord (usually left side)
Clinical
(unlikely to produce significant UA obstruction)
- Hoarseness: usually present
- Aspiration with laryngospasm during sleep:
Treatment
- Midline repositioning of cord: using injected silicone
References
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