Avaliação por imagem da paralisia de pregas vocais

Laryngeal Paralysis Recovered Two Years after a Head Trauma by Growth Hormone Treatment and Neurorehabilitation

The aim of this study was to describe the cognitive and speech results obtained after growth hormone (GH) treatment and neurorehabilitation in a man who suffered a traumatic brain injury (TBI). Seventeen months after the accident, the patient was treated with growth hormone (GH), together with neurostimulation and speech therapy. At admission, the flexible laryngoscopy revealed that the left vocal cord was paralyzed, in the paramedian position, a situation compatible with a recurrent nerve injury. Clinical and rehabilitation assessments revealed a prompt improvement in speech and cognitive functions and, following completion of treatment, endoscopic examination showed recovery of vocal cord mobility. These results, together with previous results from our group, indicate that GH treatment is safe and effective for helping neurorehabilitation in chronic speech impairment due to central laryngeal paralysis, as well as impaired cognitive functions.

Voice and swallowing implications in patients with tumors in their mediastinum

ABSTRACT Purpose: to verify voice and swallowing implications in patients diagnosed with tumors in the mediastinum. Methods: the study was carried out with 21 individuals aged between 18 and 60 years, with a diagnosis of tumors in their mediastinum. Data collection was performed at Oncology, OncoHematology and Thoracic Oncology Surgery ambulatory, and in the wards of the aforementioned clinics at an oncology reference hospital. The data was obtained by applying a questionnaire, and by evaluating voice and swallowing, using CAPE-V and O'Neil protocols, respectively. Results: there was a higher prevalence of females with mean age at 40 years. A higher prevalence of tumors in the anterior region of the mediastinum and non-Hodgkin's lymphomas was found, however, Hodgkin's lymphomas presented worse results in all the parameters of the voice evaluation. Fourteen subjects presented some degree of dysphagia, ranging from mild to moderate. Conclusion: patients with tumors in the mediastinum have significant impairments in voice and swallowing functions, especially when they are located in the anterior mediastinal region and Hodgkin lymphomas.

Characteristics of voice and personality of patients with vocal fold immobility

Purpose: To examine the voice and personality characteristics of patients diagnosed with organic dysphonia secondary to vocal fold immobility. Methods: The study comprised patients of both genders, attending the Clinic School of Speech Therapy of the Federal University of Paraíba, with otorhinolaryngological diagnosis of vocal fold immobility and speech therapy diagnosis of dysphonia. The self-assessment of voice was measured through a Vocal Screening Protocol and Voice Symptoms Scale (VoiSS), the voice was collected for auditory-perceptive evaluation, and the Factorial Personality Battery (FPB) was used. Descriptive statistical analysis was performed to determine the frequency, mean, and standard deviation of the studied variables. Results: Eight patients participated in the study, of both genders, with average age of 40.4±16.9 years. The more frequent risk factors were the personal ones (4.7±2.1). In the VoiSS, the patients presented a higher average in the limitation score (34.1±15.7). From the auditory-perceptive evaluation, moderate intensity of vocal deviation was obtained, with predominant vocal roughness (57.7±25.2). In the FPB, the patients had an average higher than the cutoff scores in neuroticism (3.8±1.4) and accomplishment (5.2±1.0). Conclusion: The predominant vocal parameter was roughness. The patients referred to a few risk factors that compromise the vocal behavior and presented the neuroticism and realization factors as a highlight in their personality. Thus, individuals with vocal fold immobility show personality characteristics that may be a reflection of their voice disorder, not a factor that determines their dysphonia.

Uncommon and rare causes of vocal fold paralysis detected via imaging

BACKGROUND

Cross-sectional imaging can be used to trace the course of the vagus nerve and its laryngeal branches to detect many of the causes of vocal fold paralysis. The most frequent aetiologies are surgical injury and tumoural involvement of the recurrent laryngeal nerve anywhere along its course.

METHOD

This review article focuses on the uncommon and rare causes of vocal fold paralysis that have been detected or diagnosed on cross-sectional imaging.

RESULTS AND CONCLUSION

Uncommon causes included a tortuous oesophagus, tracheal diverticulum, cervical osteophytes and cardiovocal syndrome. These examples are presented with clinical case histories and radiological appearances, and are discussed in the context of the current literature.