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Laryngeal three-dimensional CT scan Arytenoid cartilage does not show any deviation suggestive of dislocation. There is almost no change in the position of the vocal cords during either the inspiration or the vocalization phase, indicating that their movement is highly impaired. (A, B) Inspiration phase. (C) Vocalization phase. Yellow: arytenoid cartilage; dark brown: cricoid cartilage; light brown: thyroid cartilage; light green, V-shaped structure at ventral side: vocal cord.
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Management with ventilation is used for severe cases of coronavirus disease 2019 (COVID-19). After extubation, recurrent laryngeal nerve paralysis due to various factors may occur. Almost all cases of paralysis develop unilaterally; however, bilateral recurrent laryngeal nerve paralysis occurs rarely. Such cases may be fatal due to upper air obstru...
Context in source publication
Context 1
... three-dimensional CT scan imaging revealed no sign of dislocation of the arytenoid cartilage. Furthermore, almost no movement of the vocal cord was observed during inspiration and vocalization ( Figure 3). In addition, no other causative findings of vocal cord movement disorders such as inflammatory scar and tumor of the larynx were observed. ...
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Background:
We report the genetic etiology of a case of bilateral vocal cord paralysis in a female infant.
Case description:
The female infant developed dyspnea after birth, which improved with treatment, allowing her to be discharged from the local hospital. At 2 months of age, the child experienced a recurrence of dyspnea and was treated in a...
Citations
... The prevalence of oropharyngeal dysphagia in critically ill patients with COVID-19 is reportedly as high as 96% (Osbeck et al., 2021). In severe cases of acute COVID-19 infection, endotracheal intubation and mechanical ventilation is commonly required (Regan et al., 2021) and research suggests that these patients may then experience dysphagia in the acute infection phase as a result of prolonged recurrent laryngeal nerve paralysis and severe respi-ratory injury (Okuda et al., 2022;Jungbauer et al., 2021). As such, studies have suggested that oropharyngeal dysphagia should be considered a potential Long-COVID symptom as it may persist beyond the acute phase of COVID-19 infection (Okuda et al., 2022). ...
... In severe cases of acute COVID-19 infection, endotracheal intubation and mechanical ventilation is commonly required (Regan et al., 2021) and research suggests that these patients may then experience dysphagia in the acute infection phase as a result of prolonged recurrent laryngeal nerve paralysis and severe respi-ratory injury (Okuda et al., 2022;Jungbauer et al., 2021). As such, studies have suggested that oropharyngeal dysphagia should be considered a potential Long-COVID symptom as it may persist beyond the acute phase of COVID-19 infection (Okuda et al., 2022). Although causation is not fully established yet, multiple factors are thought to contribute to the pathophysiology of dysphagia in patients with Long-COVID, including muscle-related injury, critical illness myopathy and polyneuropathy, central nervous system impairments, impaired laryngeal sensation due to intubation, dyspnoea, and desynchronisation of breathing and swallowing, among other factors (Chuang et al., 2022;Okuda et al., 2022;Jungbauer et al., 2021). ...
... As such, studies have suggested that oropharyngeal dysphagia should be considered a potential Long-COVID symptom as it may persist beyond the acute phase of COVID-19 infection (Okuda et al., 2022). Although causation is not fully established yet, multiple factors are thought to contribute to the pathophysiology of dysphagia in patients with Long-COVID, including muscle-related injury, critical illness myopathy and polyneuropathy, central nervous system impairments, impaired laryngeal sensation due to intubation, dyspnoea, and desynchronisation of breathing and swallowing, among other factors (Chuang et al., 2022;Okuda et al., 2022;Jungbauer et al., 2021). Due to these complications, patients are at risk of delayed laryngeal elevation (Okuda et al., 2022). ...
BACKGROUND: Long-COVID occurs in individuals with a history of probable or confirmed SARS CoV-2 infection. Long-COVID can affect individuals who experience both mild and severe acute COVID-19 and can involve and affect multiple body systems. Research thus far acknowledges swallowing and communication difficulties as a characteristic of Long-COVID, however, this research lacks detail and does not address the psychosocial impact of these problems. OBJECTIVES: To establish an understanding of the presence, severity, and trajectory of swallowing and communication difficulties as a symptom of Long-COVID among adults. To investigate the psychosocial impact of these characteristics and explore supports and barriers to recovery. METHODS: The objectives were addressed by utilizing a qualitative research design. Semi-structured interviews were carried out with participants using online Zoom sessions. The interviews were recorded and transcribed and reflexive thematic analysis was used to analyse the data. RESULTS: Seven participants from Ireland, Scotland and Australia were interviewed. Four main themes were identified including dysphagia-related issues, communication-related issues, psychosocial impact of dysphagia and communication disorders, and accessing Long-COVID related healthcare for dysphagia and communication disorders. The presentation of swallowing and communication problems was diverse and had significant psychosocial and mental health consequences. Furthermore, access to healthcare services to effectively treat these issues was challenging. CONCLUSIONS: The lack of recognition of swallowing and communication as a symptom of Long-COVID and its adverse effects is a pertinent issue which warrants further research and updated guidelines for individuals living with Long-COVID and healthcare professionals alike.
... Rare cases of unilateral or bilateral vocal cord paresis or paralysis have been reported in adult patients with SARS-CoV-2 infections, many of whom have required prolonged orotracheal intubation. [7][8][9] Even rarer cases of vocal cord paralysis or paresis have been reported in patients with SARS-CoV-2 infection who have not required orotracheal intubation, suggesting that vocal cord paresis and paralysis may represent additional neuropathic sequelae of SARS-CoV-2 infection unrelated to trauma or compression from intubation. [10][11][12] The largest case series to date describes a series of 16 adult patients who tested positive for SARS-CoV-2, had no history of intubation as a result of their infection, and presented with vocal cord paresis or paralysis. ...
Bilateral vocal cord paralysis can cause obstruction of glottic airflow, resulting in respiratory distress and the need for a surgical airway. We report a case of acute onset bilateral vocal cord paralysis in a healthy adolescent patient 9 days after a mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This 15-year-old patient presented with dyspnea, tachypnea, and stridor. A fiberoptic laryngoscopy revealed bilateral vocal fold paralysis with limited vocal cord abduction causing respiratory distress. A detailed set of diagnostic test results, including blood work, imaging, and a lumbar puncture, were all negative other than her new onset diagnosis of SARS-CoV-2 infection. The patient underwent tracheostomy placement with the subsequent resolution of her symptoms. Her vocal cord function remains impaired, and the patient continues to be tracheostomy-dependent 13 months after the initial presentation. SARS-CoV-2 infection has multiple well-established neurologic complications in children. The current case suggests that vocal cord paralysis may be an additional neuropathic sequela of the virus. Vocal cord pathology should be an important consideration when constructing a differential for children presenting with voice, swallowing, or breathing complaints after SARS-CoV-2 infection.
