RESUMO
Paradoxical vocal cord motion (PVCM) is characterized by the inappropriate adduction of the true vocal cords during inspiration. Multiple causes have been proposed for this group of disorders, which share the common finding of mobile vocal cords that adduct inappropriately during inspiration and cause stridor by approximation. Management of this group of disorders has been complicated by the lack of a classification scheme to include all types of PVCM. We propose that PVCM be classified according to its underlying etiology and recognize the following causes of the disorder: 1. brainstem compression; 2. cortical or upper motor neuron injury; 3. nuclear or lower motor neuron injury; 4. movement disorder; 5. gastroesophageal reflux; 6. factitious or malingering disorder; 7. somatization/conversion disorder. Case reports are presented to illustrate the characteristic features and diagnostic evaluation used in assessing patients with PVCM. Management varies depending on the cause of PVCM and entails speech therapy, pharmacologic therapy, behavioral modification, and/or surgical intervention. Recognition of the multiple causes of PVCM allows otolaryngologists to formulate well-directed diagnostic evaluation and treatment.
Assuntos
Doenças da Laringe/diagnóstico , Doenças da Laringe/etiologia , Prega Vocal/fisiopatologia , Adolescente , Malformação de Arnold-Chiari/complicações , Lesões Encefálicas/complicações , Tronco Encefálico/patologia , Criança , Transtorno Conversivo/complicações , Diagnóstico Diferencial , Transtornos Autoinduzidos/complicações , Feminino , Refluxo Gastroesofágico/complicações , Humanos , Recém-Nascido , Doenças da Laringe/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Doença dos Neurônios Motores/complicações , Doença dos Neurônios Motores/diagnóstico , Transtornos dos Movimentos/complicações , Transtornos dos Movimentos/diagnóstico , Compressão da Medula Espinal/complicações , Compressão da Medula Espinal/diagnósticoAssuntos
Adenocarcinoma/secundário , Neoplasias Orbitárias/secundário , Neoplasias da Próstata/patologia , Adenocarcinoma/diagnóstico por imagem , Idoso , Seio Etmoidal , Humanos , Masculino , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/secundário , Tomografia Computadorizada por Raios XRESUMO
Congenital midline cervical cleft is a rare disorder with a wide range of presentations. To date, there have been fewer than 35 cases reported in the English-language literature. A rarer finding is the association of bronchogenic cysts or respiratory epithelium with the midline cleft. The clinical presentation of congenital midline cervical cleft with a cephalic skin tab, atrophic cleft, and caudal sinus may distinguish it from other conditions of the midline neck. We present an 18-month-old girl with congenital midline cervical cleft to illustrate its clinical presentation and the proper treatment of this condition.
