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颈椎骨赘导致声带麻痹:病例报告及文献综述

Cervical osteophytes causing vocal fold paralysis: case report and literature review.

作者信息

Virk J S, Majithia A, Lingam R K, Singh A

机构信息

Department of ENT, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK.

出版信息

J Laryngol Otol. 2012 Sep;126(9):963-5. doi: 10.1017/S0022215112001259.

Abstract

OBJECTIVES

To increase awareness of cervical osteophytes as an extremely rare cause of recurrent laryngeal nerve palsy; to outline the clinical approach to patients with unilateral vocal fold paralysis and to provide an update on the current management of osteoarthritis and osteophytes.

CASE REPORT

An elderly man presented with right unilateral vocal fold immobility and a small phonatory gap. By a diagnosis of exclusion, a cervical osteophyte at the level of the sixth and seventh cervical vertebrae was shown to be the cause. The patient responded to speech therapy and no further intervention was required.

METHOD

A literature review, using Medline, identified only one previously published case of vocal fold paralysis due to osteophytes secondary to osteoarthritis.

CONCLUSION

The aetiology of unilateral paralysis of the hemilarynx must be fully investigated, as the innervating system has a protracted course, particularly on the left side. Degenerative cervical spine disease, although rare, should be considered as part of the differential diagnosis.

摘要

目的

提高对颈椎骨赘作为喉返神经麻痹极其罕见病因的认识;概述单侧声带麻痹患者的临床诊疗方法,并提供骨关节炎和骨赘当前治疗方法的最新信息。

病例报告

一名老年男性出现右侧单侧声带活动障碍及微小发声间隙。通过排除诊断,发现第六和第七颈椎水平的颈椎骨赘是病因。患者对言语治疗有反应,无需进一步干预。

方法

使用医学文献数据库(Medline)进行文献综述,仅发现一例先前发表的因骨关节炎继发骨赘导致声带麻痹的病例。

结论

必须全面调查半侧喉单侧麻痹的病因,因为支配系统行程较长,尤其是在左侧。退行性颈椎疾病虽然罕见,但应作为鉴别诊断的一部分予以考虑。

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