Benhammou A, Benbouzid M-A, Bencheikh R, Boulaich M, Essakali L, Kzadri M
Service d'ORL et de Chirurgie Cervicofaciale, Hôpital des Spécialités, CHU Rabat-Salé, Maroc.
Ann Otolaryngol Chir Cervicofac. 2007 Jun;124(2):72-5. doi: 10.1016/j.aorl.2007.01.002.
To report a rare and reversible cause of bilateral vocal cord paralysis in an adult.
A 44 years old woman has consulted for a laryngeal stridor with hoarseness. This symptomatology was preceded by chronic headache and dizziness. The examination noted bilateral vocal cord paralysis in paramedian position, and a cerebellum syndrome. The patient underwent urgent tracheotomy.
A magnetic resonance imaging was performed for the etiologic research, and revealed a Chiari I malformation with a compression of the bulb. Neurosurgical decompression permitted resolution of the symptoms, and selvage of the tracheotomy was possible 2 months after surgery.
Bilateral vocal cord paralysis is rare on Chiari I malformation. It's secondary to a direct compression or an ischemia of the brain stem. The oto-rhino-laryngologists have to know this etiology to make the diagnosis early and permit a neurosurgical treatment.
报告一例成人双侧声带麻痹的罕见可逆病因。
一名44岁女性因喉喘鸣伴声音嘶哑前来就诊。此症状之前有慢性头痛和头晕。检查发现双侧声带处于旁正中位麻痹，并有小脑综合征。患者接受了紧急气管切开术。
进行磁共振成像以寻找病因，发现小脑扁桃体下疝畸形伴延髓受压。神经外科减压使症状得以缓解，术后2个月可行气管切开术拔管。
小脑扁桃体下疝畸形中双侧声带麻痹罕见。它继发于脑干的直接受压或缺血。耳鼻咽喉科医生必须了解这一病因以便早期诊断并进行神经外科治疗。
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