Abductor vocal fold palsy as a manifestation of type one Arnold Chiari malformation

Abstract

We report a rare case of type 1 Chiari malformation which presented to the Otolaryngology department with abductor vocal fold palsy following an aspiration pneumonia secondary to absent laryngeal sensation. Chiari malformations and related cases are discussed.

Adult chiari malformation presenting as bilateral vocal cord paralysis

“…Our literature search found only 2 other such reported cases in adults where vocal cord palsy and aspiration pneumonia were the initial presenting complaint for Type 1 Chiari Malformation. However the patients reported were much younger, being 44 and 54 years old respectively [5,6].…”

Anesthetic management in a child with Arnold–Chiari malformation and bilateral vocal cord paralysis

“…The incidence of vocal cord impairment is reported to be between 12.5 and 50% in type II ACM patients (2,5). Sleep apnea and aspiration are also associated with ACM (6). Stridor, apnea and bradycardia are most frequent and severe at 10–12 weeks of age.…”

Chiari Type I malformation and upper airway obstruction in adolescents

“…Initial treatment of vocal cord paralysis in Chiari I malformation is control of the airway with intubation or tracheotomy [1,13] followed by posterior fossa decompression and possible duraplasty, and/or cervical laminectomy. Ventriculoperitoneal shunts are used if hydrocephalus is present.…”

“…The Chiari malformations, a group of congenital hindbrain and spinal cord abnormalities defined by caudal herniation of the posterior fossa contents through the foramen magnum, are summarized in Table 1 [1][2][3][4][5]. Type I is the mildest of the group in severity.…”