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Vocal cord Paralysis

Vocal cord Paralysis. Moderator: DR.AVS HANUMANTHA RAO Professor, ent,head&neck surgery Done by: DR. POLUNAIDU pg in ent. Introduction:. The Vagus. Anatomy of larynx.

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Vocal cord Paralysis

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  1. Vocal cord Paralysis Moderator: DR.AVS HANUMANTHA RAO Professor, ent,head&neck surgery Done by: DR. POLUNAIDU pg in ent www.nayyarENT.com

  2. Introduction: www.nayyarENT.com

  3. www.nayyarENT.com

  4. The Vagus www.nayyarENT.com

  5. www.nayyarENT.com

  6. www.nayyarENT.com

  7. www.nayyarENT.com

  8. www.nayyarENT.com

  9. Anatomy of larynx Larynx is a midline structure, extending from root of tongue to trachea, it lies in front of c3 to c6. in children & females it lies at higher level. PARTS OF LARYNX- larynx consists of skeletal framework of cartilages connected by joints , ligaments& membranes , cartilages are moved by no. of muscles . The cavity is lined by mucus membrane Cartilages: 1, unpaired- epiglottis thyroid cricoid 2, paired- arytenoid cuneiform(c. of wrisberg) corniculate(c. of santorini) www.nayyarENT.com

  10. Ligaments& membranes: Thyrohyoid membrane(extrinsic) Thyrohyoid ligament Cricothyroid membrane(extrinsic) Cricovocal membrane(internal) Cricotracheal membrane(extrinsic) Quadrangular membrane(internal) Anterior commissure tendon(broyle’s ligament) Hyoepiglottic ligament Cricothyroid ligament Joints: Cricothyroid cricoarytenoid www.nayyarENT.com

  11. The Laryngeal Musculature • All The intrinsic muscles of the larynx are paired except transverseinterarytenoid. , all of which are innervated by the recurrent laryngeal nerve, except crico thyroid, • Muscles which change size and shape of inlet of larynx: aryepiglottic& oblique arytenoid • Muscles which move vocal cord: abductors: posterior cricoarytenoid- only abductor www.nayyarENT.com

  12. Adductors: www.nayyarENT.com

  13. Thyroarytenoid - - very broad muscle, usually divided into three parts: • Thyroarytenoideusinternus (vocalis) - adductor and major tensor of free edge of vocal fold. • Thyroarytenoideusexternus- major adductor of vocal fold • Thyroepiglotticus - shortens vocal ligaments www.nayyarENT.com

  14. Anatomy of the Larynx - Motion • Adductors of the Vocal Folds: www.nayyarENT.com

  15. Position of vocal cords www.nayyarENT.com

  16. Causes of vocal cord paralysis www.nayyarENT.com

  17. Causes of vocal cord paralysis www.nayyarENT.com

  18. Causes of vocal cord paralysis www.nayyarENT.com

  19. Causes of vocal cord paralysis www.nayyarENT.com

  20. Causes of vocal cord paralysis www.nayyarENT.com

  21. Intracranial causes www.nayyarENT.com

  22. Cranial www.nayyarENT.com

  23. Neck www.nayyarENT.com

  24. Chest www.nayyarENT.com

  25. Classification of laryngeal paralysis www.nayyarENT.com

  26. Evaluation – Patient History • Alcohol and Tobacco Usage • Voice Abuse • URI and Allergic Rhinitis • Reflux oesophagitis • Neurologic Disorders • History of Trauma or Surgery • Systemic Illness – Rheumatoid • Duration – Affects Prognosis www.nayyarENT.com

  27. Evaluation – Physical Examination www.nayyarENT.com

  28. Evaluation - Videostroboscopy www.nayyarENT.com

  29. Evaluation - Electromyography www.nayyarENT.com

  30. Evaluation - Electromyography www.nayyarENT.com

  31. Evaluation - Imaging www.nayyarENT.com

  32. Evaluation – Unilateral Paralysis www.nayyarENT.com

  33. Evaluation – Unilateral Paralysis www.nayyarENT.com

  34. Evaluation – Unilateral Paralysis www.nayyarENT.com

  35. www.nayyarENT.com

  36. Wegner and Grossman Theory www.nayyarENT.com

  37. Unilateral Superior Laryngeal Nerve Injury www.nayyarENT.com

  38. Pictures of Vocal Fold Paralysis Unilateral left vocal fold paralysis (Superior N. Paralysis) Recurrent Laryngeal N. Paralysis www.nayyarENT.com

  39. Unilateral Superior Laryngeal Nerve Injury www.nayyarENT.com

  40. Unilateral Recurrent Laryngeal Nerve Injury www.nayyarENT.com

  41. Bilateral Recurrent Laryngeal Nerve Injury www.nayyarENT.com

  42. ManagementBilateral Abductor Paralysis Inspiration Expiration www.nayyarENT.com

  43. ManagementBilateral Abductor Paralysis www.nayyarENT.com

  44. Cordotomy www.nayyarENT.com

  45. ManagementBilateral Abductor Paralysis www.nayyarENT.com

  46. Bilateral Abductor Paralysis www.nayyarENT.com

  47. Bilateral superior laryngeal nerve palsy www.nayyarENT.com

  48. 1.Tracheostomy with a cuffed tube and an oesophageal feeding tube 2.epiglottopexy www.nayyarENT.com

  49. Unilateral combined paralysis www.nayyarENT.com

  50. management www.nayyarENT.com

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