Blumin Joel H, Berke Gerald S
PENN Center for Voice, Pennsylvania Hospital, 800 Spruce St, Philadelphia, PA 19107, USA.
Arch Otolaryngol Head Neck Surg. 2002 Dec;128(12):1404-7. doi: 10.1001/archotol.128.12.1404.
To review a case series of patients with systemic neurodegenerative disease presenting to a laryngologist for workup of dysphonia and found to have bilateral vocal fold paresis.
Case series.
Tertiary care voice center.
Series of patients with neurodegenerative disorders examined for dysphonia.
History and physical examination including fiberoptic laryngoscopy were performed on all patients. Some patients underwent polysomnography.
Seven patients during a 2-year period were noted to have bilateral abductor vocal fold paresis. Five of 7 (71%) had the diagnosis of multiple system atrophy proposed by the laryngologist. All 7 patients described sleep-disordered breathing with stridor.
Patients with systemic neurodegenerative disorders such as Parkinson disease should be examined for multiple system atrophy and for evidence of bilateral vocal fold paresis. Workup for stridor should include polysomnography. Treatment of glottic obstruction in these patients includes constant positive airway pressure at night or tracheotomy. The finding of bilateral vocal fold paresis can be life threatening.
回顾一系列患有全身性神经退行性疾病的患者，这些患者因声音嘶哑就诊于喉科医生处，经检查发现双侧声带麻痹。
病例系列。
三级护理嗓音中心。
一系列因声音嘶哑接受检查的神经退行性疾病患者。
对所有患者进行病史采集和体格检查，包括纤维喉镜检查。部分患者接受了多导睡眠图检查。
在2年期间，7例患者被发现有双侧外展性声带麻痹。7例中的5例（71%）被喉科医生诊断为多系统萎缩。所有7例患者均描述有睡眠呼吸障碍伴喘鸣。
对于患有帕金森病等全身性神经退行性疾病的患者，应检查是否存在多系统萎缩以及双侧声带麻痹的证据。对喘鸣的检查应包括多导睡眠图检查。这些患者声门梗阻的治疗方法包括夜间持续气道正压通气或气管切开术。双侧声带麻痹的发现可能危及生命。
