临床误诊误治Issue(10)：19-21,3.DOI:10.3969/j.issn.1002-3429.2014.10.007
迷走神经损伤定位检查有助于单侧声带麻痹的病因诊断
Localization Examination of the Vagus Nerve in Determining the Cause of the Unilateral Vocal Cord Paralysis
李进让 1赵丹珩1
作者信息
- 1. 100048 北京，海军总医院全军耳鼻咽喉头颈外科中心
- 折叠
摘要
Abstract
Objective To evaluate the value of localization examination of the vagus nerve in determining the cause of the unilateral vocal cord paralysis. Methods The diagnostic process of a patient with unknown cause of unilateral vocal cord paralysis was retrospectively reviewed. Results The patient presented to our center for hoarseness for half a year. Idiopathic left side vocal cord paralysis was diagnosed because no positive findings were detected in many hospitals. After corresponding treatment, the vocal cord paralysis had no sign of recovery, and then the patient came to our hospital for improving his voice by autologous fat injection into the vocal fold. After medical history collection and careful physical examinations, the patient underwent electronic fibrolaryngoscope swallow study and the result showed residual food in the left pyriform sinus. Those find-ings suggested that damaged level of the vagus nerve was above the ganglion of the vagus nerve. Contrast enhanced MRI of the skull base found a mass in the jugular foramen region, considered as benign tumor. The patient refused surgical treatment and received gamma knife radiosurgery. The tumor was not changed in the 1-year follow-up. Conclusion Patients with unilateral vocal cord paralysis should not be diagnosed as vocal cord paralysis simply. The electronic fibrolaryngoscope swallow study is helpful for determining the impaired site of the vagus nerve. Then, examination should be focused on the impaired site, and the cause of the vocal cord paralysis may be found.关键词
声带麻痹/迷走神经损伤/电子喉镜/吞咽功能/颅底肿瘤/漏诊Key words
Vocal cord paralysis/Vagus nerve injuries/Electronic laryngoscope/Swallow function/Skull base neo-plasms/Missed diagnosis分类
医药卫生引用本文复制引用
李进让,赵丹珩..迷走神经损伤定位检查有助于单侧声带麻痹的病因诊断[J].临床误诊误治,2014,(10):19-21,3.
