Hulshoff A C, Dikkers F G
Rijksuniversiteit, Faculteit der Medische Wetenschappen, afd. Anatomie en Embryologie, Groningen.
Ned Tijdschr Geneeskd. 1998 Aug 22;142(34):1897-901.
Usually dysphonia is the result of a functional disorder of the larynx. It can also result from paresis or paralysis of a hemilarynx. Four patients, men aged 57, 41, 42 and 18 years, had a neurological cause of paralysis of a hemilarynx. Processes responsible for this kind of pathology can appear at three different levels: central, nuclear and peripheral. Each of the four patients had a disorder at the peripheral level: two had a tumour, in one the vagus nerve was severed during lobectomy for squamous cell carcinoma (iatrogenic), and in the last one an upper respiratory viral infection was the probable cause. Other causes of these peripheral lesions are toxicological, traumatic or idiopathic. When dysphonia does not improve within three weeks, inspection of the larynx and palpation of the neck, including examination of the aspect and mobility of the vocal folds by an otorhinolaryngologist should be performed. If paresis of a hemilarynx is seen, an orientation examination of the cranial nerves and selective additional examination is necessary, as paresis of a hemilarynx is a symptom, not a diagnosis.
通常，发音障碍是喉部功能紊乱的结果。它也可能由半侧喉轻瘫或瘫痪引起。4名男性患者，年龄分别为57岁、41岁、42岁和18岁，其半侧喉瘫痪有神经学病因。导致这种病理状况的病变可出现在三个不同层面：中枢、神经核和外周。这4名患者均在外周层面出现病变：2例患有肿瘤，1例在因鳞状细胞癌行肺叶切除术时迷走神经被切断（医源性），最后1例可能由上呼吸道病毒感染所致。这些外周病变的其他病因包括毒理学、创伤性或特发性。如果发音障碍在三周内没有改善，应由耳鼻喉科医生对喉部进行检查并触诊颈部，包括检查声带的外观和活动度。如果发现半侧喉轻瘫，则有必要对颅神经进行定向检查和选择性的额外检查，因为半侧喉轻瘫是一种症状，而非诊断结果。
