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- Title
Vocal cord paralysis secondary to spontaneous internal carotid dissection: case report and systematic review of the literature.
- Authors
Nguyen, T. T. Jean; Han Zhang; Dziegielewski, Peter T.; Seemann, Robert
- Abstract
Objectives: To present a rare case of unilateral vocal cord paralysis (VCP) secondary to spontaneous internal carotid artery dissection and to perform a literature review. Case report: A 35-year-old male presented to the emergency department with acute onset hoarseness and dysphagia. History, physical exam and laryngoscopy revealed left sided VCP without obvious cause. Magnetic Resonance Imaging (MRI) demonstrated a left internal carotid artery dissection of unknown etiology. Neurovascular surgery was consulted and treatment with aspirin was initiated. The dysphagia and hoarseness resolved in 12 weeks with long-term neurosurgery follow-up as the management plan. Methods: Systematic literature review was conducted by 3 independent reviewers. Since 1988 only 9 cases of VCP due to internal carotid artery dissection have been reported. These were reviewed for: demographics, diagnostic method, treatment and vocal cord function. Results: 7 patients had unilateral while 2 had bilateral VCP. MRI was used for diagnosis in 7 cases and 5 cases utilized a type of angiography. All received antithrombotic treatment with 5 out of the 9 patients experiencing vocal cord recovery in an average of 7.2 weeks. Conclusion: MRI is crucial in the work-up of idiopathic VCP. If an ipsilateral internal carotid artery dissection is found, antithrombotic treatment is initiated with an expectation that vocal cord mobility is likely to return.
- Subjects
PARALYSIS treatment; ASPIRIN; DEGLUTITION disorders; HOARSENESS; LARYNGOSCOPY; MAGNETIC resonance imaging; PARALYSIS; SPEECH therapy; TOMOGRAPHY; CAROTID artery dissections; DISEASE complications; VOCAL cord diseases; DIAGNOSIS; THERAPEUTICS
- Publication
Journal of Otolaryngology -- Head & Neck Surgery, 2013, Vol 42, Issue 1, p34
- ISSN
0707-7270
- Publication type
Article
- DOI
10.1186/1916-0216-42-34