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[Bilateral vocal cord paralysis due to rheumatoid arthritis].
Harefuah. 2007 Feb; 146(2):92-4, 167.H

Abstract

Cricoarythenoid arthritis can be part of rheumatoid arthritis, which can present with laryngeal symptoms as in other systemic diseases. Bilateral vocal cord paralysis can developed with the progression of cricoarythenoid arthritis and can endanger the patient who suffers from dyspnea and eventually choking. Ankylosis and no mobility of the arythenoids, secondary to chronic inflammatory process in the cricoarythenoid joint, induce in the chronic phase bilateral vocal cord paralysis with symptoms such as stridor, horseness, dyspnea and also pain during speaking and swallowing in the acute phase. The treatment for cricoarythenoid arthritis with bilateral vocal cord paralysis include operations for improvement of breathing and voice. Tracheostomy gives an immediate solution for acute medical condition of dyspnea, resulting from the location of the vocal cords in paramedian or median position, due to their immobility. There are other operations aiming to produce adduction of the vocal cords and widen the glottic inlet and thereby improve the airway condition. The family physician needs to consider the damage and fixation of the vocal cord in patients with advanced arthritis. Patients who have rheumatic arthritis need an otolaryngologic follow-up and periodic laryngoscopic evaluation in order to prevent delayed diagnosis of bilateral vocal cord paralysis which endangers the patient's airway. It is recommended to be examined by an otolaryngologist and also to evaluate the vocal cords as part of the pre-operative evaluation of the anesthesiologist, as performed in the evaluation of the larynx in patients prior to thyroidectomy. This is a case study of a patient who had severe rheumatoid arthritis and developed cricoarythenoid arthritis and bilateral vocal cord paralysis presented with stridor and dyspnea and needed an immediate tracheostomy. Cricoarythenoid arthritis with bilateral vocal cord paralysis including treatments options are discussed.

Authors+Show Affiliations

Otolaryngology-Head and Neck Unit, Hillel-Yaffe Medical Center, Hadera, Israel. braverman@hillel-yaffe.health.gov.ilNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

heb

PubMed ID

17352274

Citation

Braverman, Itzhak, et al. "[Bilateral Vocal Cord Paralysis Due to Rheumatoid Arthritis]." Harefuah, vol. 146, no. 2, 2007, pp. 92-4, 167.
Braverman I, Malatskey S, Avior G. [Bilateral vocal cord paralysis due to rheumatoid arthritis]. Harefuah. 2007;146(2):92-4, 167.
Braverman, I., Malatskey, S., & Avior, G. (2007). [Bilateral vocal cord paralysis due to rheumatoid arthritis]. Harefuah, 146(2), 92-4, 167.
Braverman I, Malatskey S, Avior G. [Bilateral Vocal Cord Paralysis Due to Rheumatoid Arthritis]. Harefuah. 2007;146(2):92-4, 167. PubMed PMID: 17352274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Bilateral vocal cord paralysis due to rheumatoid arthritis]. AU - Braverman,Itzhak, AU - Malatskey,Shelton, AU - Avior,Galit, PY - 2007/3/14/pubmed PY - 2007/4/4/medline PY - 2007/3/14/entrez SP - 92-4, 167 JF - Harefuah JO - Harefuah VL - 146 IS - 2 N2 - Cricoarythenoid arthritis can be part of rheumatoid arthritis, which can present with laryngeal symptoms as in other systemic diseases. Bilateral vocal cord paralysis can developed with the progression of cricoarythenoid arthritis and can endanger the patient who suffers from dyspnea and eventually choking. Ankylosis and no mobility of the arythenoids, secondary to chronic inflammatory process in the cricoarythenoid joint, induce in the chronic phase bilateral vocal cord paralysis with symptoms such as stridor, horseness, dyspnea and also pain during speaking and swallowing in the acute phase. The treatment for cricoarythenoid arthritis with bilateral vocal cord paralysis include operations for improvement of breathing and voice. Tracheostomy gives an immediate solution for acute medical condition of dyspnea, resulting from the location of the vocal cords in paramedian or median position, due to their immobility. There are other operations aiming to produce adduction of the vocal cords and widen the glottic inlet and thereby improve the airway condition. The family physician needs to consider the damage and fixation of the vocal cord in patients with advanced arthritis. Patients who have rheumatic arthritis need an otolaryngologic follow-up and periodic laryngoscopic evaluation in order to prevent delayed diagnosis of bilateral vocal cord paralysis which endangers the patient's airway. It is recommended to be examined by an otolaryngologist and also to evaluate the vocal cords as part of the pre-operative evaluation of the anesthesiologist, as performed in the evaluation of the larynx in patients prior to thyroidectomy. This is a case study of a patient who had severe rheumatoid arthritis and developed cricoarythenoid arthritis and bilateral vocal cord paralysis presented with stridor and dyspnea and needed an immediate tracheostomy. Cricoarythenoid arthritis with bilateral vocal cord paralysis including treatments options are discussed. SN - 0017-7768 UR - https://www.unboundmedicine.com/medline/citation/17352274/[Bilateral_vocal_cord_paralysis_due_to_rheumatoid_arthritis]_ L2 - http://www.diseaseinfosearch.org/result/592 DB - PRIME DP - Unbound Medicine ER -