ABSTRACT
There are two hypotheses that attempt to explain how a lesion in the lower part of the chest may cause paralysis of both laryngeal nerves with intermediate position of the afflicted cord. The first proposes retrograde degeneration of the vagus nerve up to its nucleus ambiguus, the second, ascending metastasis along the vagus nerve until the superior laryngeal nerve becomes paralyzed. In one case of inoperable lung cancer, the brain-stem was sectioned into a gapless series. The number of cells of the nucleus ambiguus on each side was equal, thus excluding an irreversible retrograde degeneration. However, central chromatolysis was found more than twice as often on the side of laryngeal paralysis. Intermediate vocal cord position was again associated with paralysis of both laryngeal nerves of that side.
Subject(s)
Medulla Oblongata/pathology , Vocal Cord Paralysis/pathology , Female , Humans , Lung Neoplasms/complications , Lung Neoplasms/pathology , Vagus Nerve/pathology , Vocal Cord Paralysis/etiologyABSTRACT
Seventeen cases of juvenile laryngeal papillomatosis have been seen and treated with microlaryngoscopy, removal of papillomas, and administering of autogenous vaccine. Holinger's original findings could be confirmed. The operation frequency of 9 patients was significantly reduced, 5 were improved, and 3 unchanged. In no case was an undesirable reaction to the vaccine observed. Electron microscopy showed no virus-like particles in the papilloma but a section of a vulvar wart did show the virus.
Subject(s)
Laryngeal Neoplasms/therapy , Papilloma/therapy , Papillomaviridae/immunology , Papillomavirus Vaccines , Viral Vaccines/therapeutic use , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Laryngeal Neoplasms/immunology , Laryngoscopy , Male , Microscopy, Electron , Papilloma/immunology , Papilloma/ultrastructureABSTRACT
A patient with inoperable lung cancer developed left-sided laryngeal paralysis. Her dysphonia, difficulty with swallowing, aspiration of secretions, and diminished cough reflex were improved with intracordal polytef injection for the remainder of her life. The foreign body reaction to the implant showed giant cells, few lymphocytes, and no polymorphonuclear leukocytes. This reaction may be described as a bland, chronic type consistent with the age of the implant. No areas of florid, acute reaction were found. Extrusion of part of the polytef through the cricothyroid space was observed. There were no signs of unfavorable tissue reaction, intolerance, or carcinogenicity. In a second case, part of the polytef paste exuded over the thyroid gland and was misinterpreted as a thyroid nodule. Excised 11 months after injection, the foreign body reaction appeared to be of a more acute type.
