Advertisement

Vocal Cord Immobility: Central Origin

  • Gerd Fabian Volk
  • Orlando Guntinas-LichiusEmail author
Chapter

Abstract

Vocal cord immobility of central origin, mainly as unilateral or less frequently as bilateral vocal cord palsy, is a rare symptom considering the incidence of central nervous system diseases. Theoretically, any cerebral or cerebellar disease affecting motor neurons or motor neuron pathways that are involved in laryngeal muscle movement may lead to vocal cord palsy. The most important causes are stroke, Parkinson’s disease, and multiple system atrophy. These diseases and characteristic laryngeal findings are presented in detail in this chapter. The differentiation of vocal cord immobility of central origin and diseases like essential voice tremor and laryngeal dystonia is explained. Finally, a subchapter deals with the special situation of congenital vocal cord immobility of central origin. Treatment is dominated by the treatment of the underlying neurological disease. Nevertheless, as in vocal cord immobility of peripheral origin, modern phonosurgery plays an important role in the curative or palliative care of these patients.

Keywords

Vocal cord paralysis Laryngology Stroke Parkinson’s disease Central nervous system 

Supplementary material

Video 6.1

The video shows the FEES of a patient with a stroke. Penetration and retention of saliva in the sinus piriformis and the valleculae can be observed. When swallowing blue-colored paste, the penetration and retention in the sinus piriformis and the valleculae become more obvious. Also a hypomobility of the left vocal fold can be observed (WMV 6378 kb)

Video 6.2

The video shows the FEES of another patient with a stroke. Penetration and retention of saliva in the sinus piriformis and the valleculae can be observed. When swallowing blue-colored liquid, not only the penetration and retention in the sinus piriformis and the valleculae but also aspirations are detected (WMV 5472 kb)

References

  1. 1.
    Urquhart AC, St Louis EK. Idiopathic vocal cord palsies and associated neurological conditions. Arch Otolaryngol Head Neck Surg. 2005;131(12):1086–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Addington WR, Stephens RE, Widdicombe JG, Rekab K. Effect of stroke location on the laryngeal cough reflex and pneumonia risk. Cough. 2005;1:4.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Power ML, Hamdy S, Singh S, Tyrrell PJ, Turnbull I, Thompson DG. Deglutitive laryngeal closure in stroke patients. J Neurol Neurosurg Psychiatry. 2007;78(2):141–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Senatorov VV, Satpute S, Perry K, Kaylie DM, Cole JW. Aphonia induced by simultaneous bilateral ischemic infarctions of the putamen nuclei: a case report and review of the literature. J Med Case Rep. 2013;7:83.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Venketasubramanian N, Seshadri R, Chee N. Vocal cord paresis in acute ischemic stroke. Cerebrovasc Dis. 1999;9(3):157–62.CrossRefPubMedGoogle Scholar
  6. 6.
    Ishibashi A, Fujishima I. Lesion of the nucleus solitarius leads to impaired laryngeal sensation in bulbar palsy patients. J Stroke Cerebrovasc Dis. 2012;21(3):174–80.CrossRefPubMedGoogle Scholar
  7. 7.
    Altman KW, Schaefer SD, Yu GP, Hertegard S, Lundy DS, Blumin JH, et al. The voice and laryngeal dysfunction in stroke: a report from the neurolaryngology subcommittee of the American academy of otolaryngology-head and neck surgery. Otolaryngol Head Neck Surg. 2007;136(6):873–81.CrossRefPubMedGoogle Scholar
  8. 8.
    Merati AL, Heman-Ackah YD, Abaza M, Altman KW, Sulica L, Belamowicz S. Common movement disorders affecting the larynx: a report from the neurolaryngology committee of the AAO-HNS. Otolaryngol Head Neck Surg. 2005;133(5):654–65.CrossRefPubMedGoogle Scholar
  9. 9.
    Blumin JH, Pcolinsky DE, Atkins JP. Laryngeal findings in advanced Parkinson’s disease. Ann Otol Rhinol Laryngol. 2004;113(4):253–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Sanabria J, Ruiz PG, Gutierrez R, Marquez F, Escobar P, Gentil M, et al. The effect of levodopa on vocal function in Parkinson’s disease. Clin Neuropharmacol. 2001;24(2):99–102.CrossRefPubMedGoogle Scholar
  11. 11.
    Kompoliti K, Wang QE, Goetz CG, Leurgans S, Raman R. Effects of central dopaminergic stimulation by apomorphine on speech in Parkinson’s disease. Neurology. 2000;54(2):458–62.CrossRefPubMedGoogle Scholar
  12. 12.
    Ozawa T, Paviour D, Quinn NP, Josephs KA, Sangha H, Kilford L, et al. The spectrum of pathological involvement of the striatonigral and olivopontocerebellar systems in multiple system atrophy: clinicopathological correlations. Brain. 2004;127(Pt 12):2657–71.CrossRefPubMedGoogle Scholar
  13. 13.
    Blumin JH, Berke GS. Bilateral vocal fold paresis and multiple system atrophy. Arch Otolaryngol Head Neck Surg. 2002;128(12):1404–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Woodson G. Management of neurologic disorders of the larynx. Ann Otol Rhinol Laryngol. 2008;117(5):317–26.CrossRefPubMedGoogle Scholar
  15. 15.
    Bigliardi G, Malaguti MC, Sola P, Georgoulopoulou E, Tondelli M, Barbi F, et al. Bilateral vocal cord paralysis: a rare onset of amyotrophic lateral sclerosis. Arch Neurol. 2010;67(7):897–8. author reply 8-9CrossRefPubMedGoogle Scholar
  16. 16.
    Rontal E, Rontal M, Wald J, Rontal D. Botulinum toxin injection in the treatment of vocal fold paralysis associated with multiple sclerosis: a case report. J Voice. 1999;13(2):274–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Yoskovitch A, Enepekides DJ, Hier MP, Black MJ. Guillain-Barre syndrome presenting as bilateral vocal cord paralysis. Otolaryngol Head Neck Surg. 2000;122(2):269–70.CrossRefPubMedGoogle Scholar
  18. 18.
    Sulica L, Louis ED. Clinical characteristics of essential voice tremor: a study of 34 cases. Laryngoscope. 2010;120(3):516–28.CrossRefPubMedGoogle Scholar
  19. 19.
    Elble RJ. Diagnostic criteria for essential tremor and differential diagnosis. Neurology. 2000;54(11 Suppl 4):S2–6.PubMedGoogle Scholar
  20. 20.
    Cohen O, Pullman S, Jurewicz E, Watner D, Louis ED. Rest tremor in patients with essential tremor: prevalence, clinical correlates, and electrophysiologic characteristics. Arch Neurol. 2003;60(3):405–10.CrossRefPubMedGoogle Scholar
  21. 21.
    Gardner GM, Altman JS, Balakrishnan G. Pediatric vocal fold medialization with silastic implant: intraoperative airway management. Int J Pediatr Otorhinolaryngol. 2000;52(1):37–44.CrossRefPubMedGoogle Scholar
  22. 22.
    Dedo DD. Pediatric vocal cord paralysis. Laryngoscope. 1979;89(9 Pt 1):1378–84.CrossRefPubMedGoogle Scholar
  23. 23.
    Bathini L, Jomah M, Krajacic A, Jeffery C, Campbell S, El-Hakim H. Acquired bilateral adductor laryngeal paralysis in neonates and children: a case series and a systematic review. Int J Pediatr Otorhinolaryngol. 2014;78(11):1866–9.CrossRefPubMedGoogle Scholar
  24. 24.
    King EF, Blumin JH. Vocal cord paralysis in children. Curr Opin Otolaryngo Head Neck Surg. 2009;17(6):483–7.CrossRefGoogle Scholar
  25. 25.
    Cohen SM, Elackattu A, Noordzij JP, Walsh MJ, Langmore SE. Palliative treatment of dysphonia and dysarthria. Otolaryngol Clin N Am. 2009;42(1):107–21.CrossRefGoogle Scholar
  26. 26.
    Hill AN, Jankovic J, Vuong KD, Donovan D. Treatment of hypophonia with collagen vocal cord augmentation in patients with parkinsonism. Mov Disord. 2003;18(10):1190–2.CrossRefPubMedGoogle Scholar
  27. 27.
    Sinclair CF, Gurey LE, Brin MF, Stewart C, Blitzer A. Surgical management of airway dysfunction in Parkinson’s disease compared with Parkinson-plus syndromes. Ann Otol Rhinol Laryngol. 2013;122(5):294–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyJena University HospitalJenaGermany
  2. 2.Department of OtorhinolaryngologyInstitute of Phoniatry/Pedaudiology, Jena University HospitalJenaGermany

Personalised recommendations