一氧化碳中毒所致声带损伤引起的失音
Aphonia due to vocal cord impairment induced by carbon monoxide poisoning.
作者信息
Koga Shunsuke, Sadahiro Tomohito, Ito Shoichi, Asahina Masato, Oda Shigeto
机构信息
Department of Emergency and Critical Care Medicine Chiba University Graduate School of Medicine Chiba Chiba Japan.
Department of Neurology Chiba University Graduate School of Medicine Chiba Chiba Japan.
出版信息
Acute Med Surg. 2014 Jan 28;1(2):119-121. doi: 10.1002/ams2.19. eCollection 2014 Apr.
CASE
We describe a case of a 22-year-old woman with alteration in consciousness and aphonia due to vocal cord impairment after carbon monoxide exposure. Brain magnetic resonance imaging revealed high signal intensity in bilateral globus pallidus and the pars reticulata of the substantia nigra on T2- and diffusion-weighted images. Laryngeal fiberscopy showed bilateral immobilization of the vocal cords in median position during both inspiration and phonation. Although the effects of hyperbaric oxygen therapy remain ambiguous, these symptoms and magnetic resonance imaging findings subsided.
OUTCOME
Aphonia due to vocal cord impairment, as a presenting symptom of carbon monoxide poisoning, has not been previously reported. We considered the cause of aphonia was vocal cord abductor paralysis or dystonia of intralaryngeal muscles after the carbon monoxide exposure.
CONCLUSION
Even though aphonia is an unusual symptom in a patient with carbon monoxide poisoning, it must be taken into consideration.
病例
我们描述了一名22岁女性的病例，该患者在一氧化碳中毒后因声带损伤出现意识改变和失音。脑磁共振成像显示，在T2加权像和弥散加权像上，双侧苍白球及黑质网状部呈高信号强度。喉镜检查显示，吸气和发声时双侧声带均固定于中位。尽管高压氧治疗的效果仍不明确，但这些症状和磁共振成像表现均已消退。
结果
作为一氧化碳中毒的首发症状，因声带损伤导致的失音此前尚未见报道。我们认为失音的原因是一氧化碳中毒后声带外展肌麻痹或喉内肌肌张力障碍。
结论
尽管失音在一氧化碳中毒患者中是一种不常见的症状，但仍必须予以考虑。
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