Kanemaru Shin-Ichi, Fukushima Hideyuki, Kojima Hisayoshi, Kaneko Ken-ichi, Yamashita Masaru, Ito Juichi
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54, Kawahara-Cho, Syogoin Sakyo-Ku, Kyoto 606-8507, Japan.
Auris Nasus Larynx. 2007 Sep;34(3):401-3. doi: 10.1016/j.anl.2006.11.007. Epub 2007 Jan 11.
This report describes a very rare case of myasthenia gravis (MG) localized to the larynx, with the onset of dyspnea requiring tracheotomy. The vocal cords of this patient were fixed in the paramedian position. Under fiberscopic observation, improvement of laryngeal function was demonstrated after intravenous injection of edrophonium. However, no voice change occurred. The posterior crico-arytenoid muscle has the sole responsibility of abducting the vocal cord; thus, it is concluded that the dyspnea was caused by the selective paralysis of this muscle. We suggest that MG should be considered in cases of vocal cord paralysis of unknown etiology.
本报告描述了一例非常罕见的局限于喉部的重症肌无力（MG）病例，患者因呼吸困难发作而需要进行气管切开术。该患者的声带固定于旁正中位。在纤维镜观察下，静脉注射依酚氯铵后喉部功能得到改善。然而，未出现声音变化。环杓后肌是声带外展的唯一负责肌肉；因此，得出结论认为呼吸困难是由该肌肉的选择性麻痹所致。我们建议，对于病因不明的声带麻痹病例应考虑重症肌无力。
