Causes of vocal cord paralysis

السؤال

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ماهو اسباب شلل الاوتار الصوتية في حال ان جميع التحاليل المختبرية  سليمة؟

what are the causes of paralysis of vocal cord in the absence of any laboratory findings

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الجواب

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Mechanical causes:
 
1-Acute complications of intubation.
2-Arytenoid dislocation.
3-Injury to the Recurrent Laryngeal Nerve (RLN) due to anterior displacement of thyroid cartilage relative to the 4-cricoid cartilage.
5-Hyperextension of the neck that stretches the vagus nerve.
6-Laryngeal mask airway.
7-Excessive cuff pressure that compresses the RLN as it enters the larynx.
8-Chronic complications of intubation.
9-Posterior glottic stenosis (PGS) due to prolonged or traumatic intubation.
10-Excessive cuff pressure compressing the RLN as it enters the larynx.
11-Sofferman nasogastric tube syndrome.

Inflammatory processes that affect the cricoarytenoid (CA) joint:
1-Rheumatoid arthritis.
2-Gout.
3-Tietze syndrome.
4-Ankylosing spondylitis.
5-Reiter syndrome.
6-Crohn disease.
7-Collagen vascular disease.
8-Mumps.
9-Systemic lupus erythematosus.

Inflammatory processes that affect the larynx:
1-Wegener granulomatosis.
2-Amyloidosis.
3-Sarcoidosis.
4-Cicatricial pemphigoid.
5-Tuberculosis.
6-Syphilis.
7-Gastroesophageal reflux disease.
8-Relapsing polychondritis.

Malignancy:
1-Laryngeal neoplasm.
2-Chondromas and chondrosarcomas.
3-Squamous cell carcinoma.

Surgery:
A-Bilateral injury may be caused by the following:
1-Thyroid surgery.
2-Parathyroid surgery.
3-Esophageal surgery.
4-Tracheal surgery.
5-Brainstem surgery.

B-Contralateral injury after an earlier unrecognized ipsilateral injury may be caused by the following:
1-Completion thyroid surgery.
2-Contralateral carotid endarterectomy.
3-Anterior approach to cervical disk.

C-Endolaryngeal surgery with a carbon dioxide laser may injure the posterior glottis.

Neurologic causes:
1-Arnold-Chiari malformation.
2-Meningomyelocele.
3-Diabetes mellitus.
4-Amyotrophic lateral sclerosis.
5-Myasthenia gravis.
6-Möbius syndrome.
7-Charcot-Marie-Tooth disease.
8-Postpolio syndrome.
9-Shy-Drager syndrome.
10-Creutzfeldt-Jacob disease.
11-Hydrocephalus.
12-Synkinesis of the RLN.
13-Lyme disease.

Radiation injury:
1-Radiation therapy.
2-Postirradiation fibrosis of the CA, vocal folds, or both.
3-Chondronecrosis.

Metabolic causes:
1-Hypokalemia.
2-Hypocalcemia.
3-Diabetes mellitus.

Toxins:
1-Vincristine.
2-Taxol.
3-Organophosphates.

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