D / D OF VOCAL CORD PARALYSIS Differential diagnosis Causes - PowerPoint PPT Presentation

Loading...

PPT – D / D OF VOCAL CORD PARALYSIS Differential diagnosis Causes PowerPoint presentation | free to download - id: 3b84e5-YjRkO



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

D / D OF VOCAL CORD PARALYSIS Differential diagnosis Causes

Description:

D / D OF VOCAL CORD PARALYSIS Differential diagnosis Causes Distinguishing features Differential diagnosis Causes 1- Individual causes 2- Groups ... – PowerPoint PPT presentation

Number of Views:180
Avg rating:3.0/5.0
Slides: 22
Provided by: pmcEduPkD
Learn more at: http://www.pmc.edu.pk
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: D / D OF VOCAL CORD PARALYSIS Differential diagnosis Causes


1
(No Transcript)
2
D / D OF VOCAL CORD PARALYSIS
3
Differential diagnosis
  • Causes
  • Distinguishing features

4
Differential diagnosis
  • Causes
  • 1- Individual causes
  • 2- Groups

5
Differential diagnosis
  • Distinguishing features
  • 1- History
  • 2- Physical examination
  • 3- Investigations

6
Diseases of the Larynx
  • Congenital
  • Traumatic
  • Inflammatory
  • Neoplastic
  • Miscellaneous

7
Vocal Cord Paralysis
  • Causes in the CNS
  • Causes in the base of skull
  • Causes in Parapharyngeal space
  • Causes in the neck.
  • Causes in the chest.
  • Neurological causes.

8
D/D V.C. Paralysis - Causes in CNS
  • Infections -Encephalitis, meningitis.
  • Trauma
  • Vascular causes - infarction., hemorrhage,
    aneurysm.

9
D/D V.C. Paralysis - Causes in base of skull
  • Inflammations - Chronic specific
  • Trauma
  • Bone disease e.g., pagets disease osteopetrosis,
    osteogenosis imperfecta
  • TUMOURS
  • Primary- glomus jugulare.
  • Secondary- parotid, Nasopharynx.

10
D/D V.C. Paralysis - Causes in Parapharyngeal
Space
  • Inflammations - Parapharyngeal abscess
  • Trauma
  • Tumour- Parotid, Nasopharynx, Secondaries.

11
D/D V.C. Paralysis - Causes in the Neck
  • Trauma
  • Surgical thyroid, larynx, esophagus etc.
  • Physical blunt penetrating.
  • Inflammation,
  • Non specific and specific.
  • Tumours.
  • Larynx, esophagus, thyroid, trachea,
    lymphomas and secondaries.

12
D/D V.C. Paralysis - Causes in Chest (left side
only)
  • Tumours
  • Carcinoma
  • Retrosternal goiter
  • Ca esophagus
  • Mediastinal malignancy
  • Tuberculosis
  • Aortic aneurysm
  • Rt. Ventricular hypertrophy

13
D/D V.C. Paralysis - Neurological lesions
  • Motor neuron disease.
  • Multiple sclerosis.
  • Guillain barre syndrome
  • Myasthenia gravis
  • Strychnine poisoning.
  • Tetanus
  • Rheumatoid arthritis
  • Diphtheria, infectious mononucleosis
  • Leukaemia.

14
SEMON,S LAW
  • This law is of his historical value only
  • It states that the abductors and adductors lie
    in separate bundles in recurrent laryngeal nerve.
    In an advancing lesion, the abductors which are
    phylogenitcally younger, are paralyzed first and
    cord lies in paramedian position. Then the
    adductors which are phylogenitcally older, are
    paralyzed and cord lies in lateral (cadaveric)
    position.

15
WEGENER AND GROSS MAN THEORY
  • It states , that if there is pure recurrent
    laryngeal nerve paralysis the cord lies in
    paramedian position and if there is combined
    recurrent laryngeal nerve and superior laryngeal
    nerve paralysis, the cord lies in lateral
    position.

16
TYPES OF PARALYSIS
  • UNILATRAL ABDUCTOR PARALYSIS
  • UNILATRAL ADDUCTOR PARALYSIS
  • BILATRAL ABDUCTOR PARALYSIS
  • BILATRAL ADDUCTOR PARALYSIS

17
UNILATRAL ABDUCTOR PARALYSIS
  • 1. Paralysis of recurrent laryngeal
  • nerve
  • 2. Vocal cord lies in paramedian position
  • 3. Initial hoarseness
  • 4. No regurgitation
  • 5. Vocal cord compensation occurs leading to
    improvement of voice
  • 6. Teflon paste injection---- Treatment

18
UNILATRAL ADDUCTOR PARALYSIS
  • 1. Paralysis of both superior and recurrent
    laryngeal
  • nerves
  • 2. Vocal cord lies in Lateral (cadaveric)
    position
  • 3. Weak husky voice
  • 4. There is aspiration of food and fluid
  • 5. Vocal cord compensation occurs leading to
    improvement of voice
  • 6. Teflon paste injection usually not possible.
    Medialization of vocal cord or reverse cordopexy
    ---- Treatment

19
BILATRAL ABDUCTOR PARALYSIS
  • 1.Paralysis of both recurrent laryngeal
  • nerves
  • 2. Thyroid surgery - cause
  • 3. Both vocal cord lies in paramedian position
  • 4. Severe dyspnoea and stridor.
  • 5. Voice is good and there is no regurgitation
  • 6. Vocal cord compensation may occurs leading to
    improvement
  • 7. Immediate tracheostomy followed by laser,
    woodman, s operation or aytenoidectomy or valved
    tracheostomy--- Treatment

20
BILATRAL ADDUCTOR PARALYSIS
  • 1. Paralysis of combined both recurrent and
    superior laryngeal nerves
  • 2. Psychiatric Illness or widespread neurological
    lesion or neoplastic lesion in the base of skull,
    upper neck etc.
  • 3. Both vocal cord lies in lateral (cadaveric)
    position
  • 4. Severe regurgitation of food and fluid.
  • 5. Voice is breathy
  • 6. Vocal cord compensation may occurs leading to
    improvement
  • 7. If compensation does not occur than total
    laryngectomy and epiglottopexy ---- Treatment

21
(No Transcript)
About PowerShow.com