Post-intubation vocal cord paralysis: the viral hypothesis. A case report

Marie, Jean; Keghian, Jerôme; Mendel, Isabelle; Gueït, I.; Dehesdin, D.; Andrieu-Guitrancourt, J

doi:10.1007/s004050100357

Cited by 18 publications

(17 citation statements)

References 7 publications

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“…Vocal cord paralysis without a history of intubation has been reported in association with herpes simplex virus, varicella zoster virus, EBV and cytomegalovirus. 13 Mechanical and neurogenic mechanisms have been proposed, however, causality or an exact pathogenic mechanism have not been established. Extension of adjacent inflammation can cause unilateral or bilateral reduction in mobility of the small muscles and joints of the larynx.…”

Section: Discussionmentioning

confidence: 99%

Pediatric COVID-19 presenting as supraglottitis with vocal cord hypomobility

Nadiger

Ness-Cochinwala

Sanchez-Vegas

et al. 2021

SAGE Open Medical Case Reports

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In the United States, an estimated 7.3% of confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) are among persons aged less than 18 years. Data regarding clinical manifestations in this age group are still evolving. An upper airway predilection has been reported in children. We describe the case of a 15-year-old female with supraglottitis and unilateral hypomobility of vocal cord with concern for critical airway, associated with COVID-19. She was managed by a multidisciplinary team including critical care, infectious diseases, and otolaryngology. This report adds to the sparse but evolving body of literature on the clinical presentation of COVID-19 disease in children.

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Section: Discussionmentioning

confidence: 99%

Pediatric COVID-19 presenting as supraglottitis with vocal cord hypomobility

Nadiger

Ness-Cochinwala

Sanchez-Vegas

et al. 2021

SAGE Open Medical Case Reports

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“…The mechanism could be the compression of the recurrent laryngeal nerve by the lateral arytenoids, thyroid cartilage and an inflated cuff from an endotracheal tube [1] . Marie et al [14] advocated that the recurrent laryngeal nerve, after intubation, could suffer from viral infections triggered after local trauma, such as herpes zoster. In addition, trauma causing VCP may be due to traffic accidents and penetration of the neck.…”

Section: Discussionmentioning

confidence: 99%

Etiology of Vocal Cord Paralysis

Chen¹,

Jen

Wang³

et al. 2007

ORL

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Objective: Vocal cord paralysis (VCP) is a sign of a certain underlying disease, a diagnosis which can be attributed to various causes. This study intends to analyze the contemporary etiology of VCP in a tertiary medical center. Materials and Methods: A retrospective review of medical records from June 2000 to December 2004 of hospitalized patients with VCP was done to determine the etiology. Results: Two hundred and ninety-one patients with a determined etiology were identified, consisting of 176 males and 115 females. Unilateral VCP was present in 259 patients, while 32 presented with bilateral VCP. The causes were surgical in 40.2%, neoplastic in 29.9%, idiopathic in 10.7%, traumatic in 8%, central in 3.8%, radiation-induced in 3.4%, inflammatory in 2%, cardiovascular in 1.7% and other causes in 0.3% of the cases. Thyroidectomy represented the most common surgery for VCP and was the cause in 57 patients. Lung cancer was responsible for 34 cases and was the most common neoplastic etiology. In males, neoplasm was the most common cause occurring in 63 of 176 males, whereas surgery was most frequent in 59 of 115 females. Conclusion: Surgical trauma, mainly thyroidectomy, is the most common cause of VCP in hospitalized patients. The possibility of a neoplasm must be ruled out before VCP is labeled idiopathic. A benign thyroid tumor could also cause VCP. Besides, radiation-induced cranial nerve paralysis in head and neck cancer may play a significant role.

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“…A large portion of cases (29.8–65.7%) are reported as idiopathic in etiology [ 8 ]. Many speculate that viral etiologies could account for a significant portion of the cases currently considered idiopathic [ 9 ]. Retrospective studies have supported this and found that a high number of upper respiratory infections correlated with idiopathic cases of VCP [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

An 18-Year-Old Female Experiences Unilateral Vocal Cord Paralysis during Mild COVID-19 Infection

Coggins

Wright

Underbrink

2022

Case Reports in Otolaryngology

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The COVID-19 pandemic has shown with certainty that SARS-CoV-2 can cause a variety of clinical findings, with some of the most notable being lasting chemosensory changes. Severe infections with SARS-CoV-2 can also lead to a variety of complications. For example, vocal cord paralysis can be caused by trauma sustained during intubation, which is a necessary procedure for many severe cases. Rarely, SARS-CoV-2 related vocal cord paralysis has occurred outside the context of intubation. These cases contribute to an emerging assortment of evidence supporting the neuropathic capacity of SARS-CoV-2. This report documents a case of COVID-19 related vocal cord paralysis in an 18-year-old female. The patient had a significant history of muscle tension dysphonia, chronic laryngitis, and vocal cord nodules. The patient developed vocal cord paralysis concurrently with the onset of mild viral symptoms and was never intubated or hospitalized. Based on the onset of symptoms and other causes being excluded with CT, a diagnosis of COVID-19-related vocal cord paralysis was performed.

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Post-intubation vocal cord paralysis: the viral hypothesis. A case report

Cited by 18 publications

References 7 publications

Pediatric COVID-19 presenting as supraglottitis with vocal cord hypomobility

Pediatric COVID-19 presenting as supraglottitis with vocal cord hypomobility

Etiology of Vocal Cord Paralysis

An 18-Year-Old Female Experiences Unilateral Vocal Cord Paralysis during Mild COVID-19 Infection

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