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与新型冠状病毒肺炎相关的单侧声带麻痹病例

Unilateral Vocal Cord Paralysis Case Related to COVID-19.

作者信息

Korkmaz Müge Özçelik, Güven Mehmet

机构信息

Otorhinolaryngology Department, Medical Faculty, Training and Research Hospital, Sakarya University, Sakarya, Turkey.

出版信息

SN Compr Clin Med. 2021;3(11):2319-2321. doi: 10.1007/s42399-021-01024-w. Epub 2021 Jul 23.

Abstract

Although the most common neuro-otolaryngological findings associated with COVID-19 infection are chemosensory changes, it should be known that these patients may present with different clinical findings. We present a 57-year-old woman who developed progressive hoarseness while suffering from COVID-19 infection without a history of chronic disease or any other etiological cause. Laryngeal fiberscopy revealed left vocal cord fixed at the cadaveric position and there was a 5-6-mm intraglottic gap during phonation. No other etiological causes were found in the examinations performed with detailed ear-nose-throat examination, neurological evaluations, and imaging methods. Injection laryngoplasty was applied to the patient, and voice therapy was initiated, resulting in significant improvement in voice quality. The mechanism of the idiopathic vocal cord paralysis remains unclear; it is suspected to be related to COVID-19 neuropathy, because the patient had no pre-existing vascular risk factors or evidence of other neurologic diseases on neuroimaging. Laryngeal nerve palsies may represent part of the neurologic spectrum of COVID-19. When voice changes occur in patients during COVID 19 infection, the possibility of vocal cord paralysis due to peripheral nerve damage caused by the SARS-CoV-2 should be considered.

摘要

尽管与新冠病毒感染相关的最常见神经耳喉科表现是化学感觉改变,但应该知道这些患者可能会出现不同的临床表现。我们报告一名57岁女性,在感染新冠病毒期间出现进行性声音嘶哑,无慢性疾病史或任何其他病因。喉镜检查显示左侧声带固定于尸体位,发声时声门内间隙为5 - 6毫米。在进行详细的耳鼻喉检查、神经学评估和影像学检查时未发现其他病因。对该患者实施了注射式喉成形术,并开始进行语音治疗,声音质量有显著改善。特发性声带麻痹的机制尚不清楚;怀疑与新冠病毒神经病变有关,因为该患者没有既往血管危险因素,神经影像学检查也没有其他神经系统疾病的证据。喉神经麻痹可能是新冠病毒神经系统表现的一部分。当新冠病毒感染患者出现声音变化时,应考虑由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的周围神经损伤导致声带麻痹的可能性

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a601/8300071/c5e7465700f4/42399_2021_1024_Fig1_HTML.jpg

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