Answers:
Pt presents with dysphonia and a hx of aspiration pneumonia. On laryngoscopy the left vocal cord is found to remain lateral even during phonation. Where is the most likely area for the lesions causing this paralysis?
A) At the site of the false vocal cord
B) At the site of the true vocal cord
C) Below the origin of the superior laryngeal nerve
D) Above the origin of the superior laryngeal nerve
What are two procedures used to medialize paralyzed vocal folds?
1. Injection Laryngoplasty=injection of inert substance into cord
2. Laryngeal framework=placement of silastic implant via thyroid window.
MC Question:
With regards to unilateral recurrent laryngeal paralysis, how long does it take, on average for a patients voice to compensate for the paralyized cord and regain some function?
A) 1-6 months
B) 6-18 months
C) 2-3 years
D) They never compensate
Free Response Questions:
In unilateral complete vagal paralysis, what treatment modality is preferred; injection laryngoplasty or laryngeal framework using a silastic implant?
In unilateral complete vagal paralysis, what treatment modality is preferred; injection laryngoplasty or laryngeal framework using a silastic implant?
Quick Facts:
Bilateral Complete Vagal Nerve Paralysis
-often due to neurologic cause (infarct, MS, ALS)
-complete lack of supraglottic sensation leads to aspiration.
-presents w/ weak breathy voice and hx of choking/dysphagia.
-treat by preventing aspiration while maintaining adequate nutrition w/ g-tube if necessary.
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