Vocal-cord-slides-040418

Vocal-cord-slides-040418 - 1 Vocal Cord Paralysis...

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Unformatted text preview: 1 Vocal Cord Paralysis Medialization Laryngoplasty University of Texas Medical Branch Shashidhar S. Reddy, MD, MPH Faculty Sponsor: Anna Pou, MD April 2004 2 Overview Anatomy of the Larynx Function of the Larynx Causes of Vocal Cord Paralysis Evaluation of Vocal Cord Paralysis Anterior TVC Medialization Posterior TVC Medialization Overview of Treatment for Bilateral Vocal Cord Paralysis Conclusion (Key Points) 3 Anatomy of the Larynx - Cartilages 4 Anatomy of the Larynx - Cartilages 5 Anatomy of Larynx - Muscles 6 Anatomy of Larynx - Muscles 7 Anatomy of Larynx - Nerves 8 Anatomy of Larynx - Nerves 9 Anatomy of Larynx - Motion Adductors of the Vocal Folds: 10 Anatomy of the Larynx - Motion Adductors of the Vocal Folds: 11 Anatomy of the Larynx - Motion Abductor of Larynx: 12 Anatomy of Larynx - Histology 13 Function of Larynx Passage for Respiration Prevents Aspiration Allows Phonation Allows Stabilization of Thorax 14 Respiration 15 Phonation 16 Vocal Cord Paralysis Etiology, Preoperative Evaluation, Treatment 17 Etiology Causes of Vocal Cord Paralysis in Adults: Cause Unilateral % Bilateral % Surgery 24 26 Idiopathic 20 13 Malignancy 25 17 Trauma 11 11 Neurologic 8 13 Intubation 8 18 Other 5 5 Benninger et al. , Evaluation and Treatment of the Unilateral Paralyzed Vocal Fold. Otolaryngol Head Neck Surg 1994;111-497-508 18 Evaluation Patient History Alcohol and Tobacco Usage Voice Abuse URI and Allergic Rhinitis Reflux Neurologic Disorders History of Trauma or Surgery Systemic Illness Rheumatoid Duration Affects Prognosis 19 Evaluation Physical Examination Complete Head and Neck Examination Flexible Fiberoptic Laryngoscopy 90 degree Hopkins Rod- lens Telescope Adequacy of Airway, Gross Aspiration Assess Position of Cords Median, Paramedian, Lateral Posterior Glottic Gap on Phonation 20 Evaluation - Videostroboscopy Demonstrates subtle mucosal motion abnormalities Video-documentation (not available online) 21 Evaluation - Electromyography Assesses integrity of laryngeal nerves Differentiates denervation from mechanical obstruction of vocal cord movement Electrode in Thyroarytenoid and Cricothyroid 22 Evaluation - Electromyography Normal Joint Fixation Post. Scar Fibrillation Denervation Polyphasic Synkinesis Reinnervation 23 Evaluation - Imaging Chest X-ray Screen for intrathoracic lesions MRI of Brain Screen for CNS disorders CT Skull Base to Mediastinum Direct Laryngoscopy Palpate arytenoids, especially when no L- EMG 24 Evaluation Unilateral Paralysis Preoperative Evaluation Speech Therapy Assess patients vocal requirements...
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This note was uploaded on 12/28/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Vocal-cord-slides-040418 - 1 Vocal Cord Paralysis...

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