[脊髓脊膜膨出和脑积水患儿声带麻痹所致吸气性喘鸣]

[Inspiratory stridor due to vocal cord paralysis in children with myelomeningocele and hydrocephalus].

作者信息

Klinkers H M

出版信息

Tijdschr Kindergeneeskd. 1982 Feb;50(1):19-24.

Abstract

Inspiratory stridor in combination with myelomeningocele and increased intracranial pressure is caused by bilateral vocal cord paralysis in children with Arnold-Chiari-deformation. The diagnosis of bilateral vocal cord paralysis can be established by direct laryngoscopy performed without general anesthesia. As emergency measures naso-tracheal intubation, tracheostomy and immediate ventricular puncture are recommended. Reduction of intracranial pressure has always to be performed within 24 hours. The bilateral vocal cord paralysis is totally reversible if the inracranial pressure is decreased timely. The bilateral vocal cord paralysis becomes irreversible when degeneration of the nucleus ambiguus occurs secondary to peripheral lesions of the nervus vagus.

摘要

阿诺德-奇阿里畸形患儿出现吸气性喘鸣并伴有脊髓脊膜膨出和颅内压升高是由双侧声带麻痹引起的。双侧声带麻痹的诊断可通过在无全身麻醉的情况下进行直接喉镜检查来确立。作为紧急措施，建议进行鼻气管插管、气管切开术和立即进行脑室穿刺。颅内压降低必须在24小时内进行。如果颅内压及时降低，双侧声带麻痹是完全可逆的。当中枢迷走神经核继发于迷走神经周围病变而发生变性时，双侧声带麻痹将变为不可逆。