Displaying publications 1 - 20 of 33 in total

  1. Irfan M, Yaroko AA, Soleh MN, Periasamy C
    Med J Malaysia, 2013 Apr;68(2):183-5.
    PMID: 23629575
    A massive goiter may constrict the trachea resulting in shortness of breath. Recurrent laryngeal nerve compression may cause vocal cord paralysis. We highlight a case of a 62- year-old female with a 30 year history of an anterior neck swelling gradually increasing in size. She presented with acute symptoms of upper airway obstruction and voice changes. Emergency thyroidectomy was performed by dividing the middle part of the gland using ultrasonic scissors. The recovery was uneventful and the patient regained normal vocal cord function post operatively.
    Matched MeSH terms: Vocal Cord Paralysis*
  2. Lee SS
    Med J Malaysia, 1990 Sep;45(3):239-43.
    PMID: 2152086
    Six of 16 patients presenting to the University Hospital Kuala Lumpur with unilateral recurrent laryngeal nerve paralysis were treated with teflon injection of the paralysed vocal cord. The results are presented and the role of surgical therapy, in particular teflon injection is reviewed.
    Matched MeSH terms: Vocal Cord Paralysis/pathology; Vocal Cord Paralysis/therapy*
  3. Mohd Umbaik NA, Mohamad I, Nik Hassan NFH
    J Craniofac Surg, 2020 10;31(7):2064-2065.
    PMID: 32890162 DOI: 10.1097/SCS.0000000000006839
    Matched MeSH terms: Vocal Cord Paralysis*
  4. Hasniah AL, Asiah K, Mariana D, Anida AR, Norzila MZ, Sahrir S
    Med J Malaysia, 2006 Dec;61(5):626-9.
    PMID: 17623966 MyJurnal
    Congenital upper airway obstruction is a relatively rare but important cause of major respiratory problems in the neonatal period. Vocal cord paralysis is the second most common cause of congenital airway obstruction presenting with neonatal stridor. It is often the reason for the failure of neonates to wean from the respiratory support. A retrospective analysis of medical record review was conducted. There were seven paediatric patients diagnosed with bilateral vocal fold paralysis in the past three years, of which five were recently diagnosed. All patients underwent flexible with/without rigid bronchoscopes to confirm the diagnosis. This case series highlight our experience in managing the problem of bilateral vocal cord paralysis in the paediatric population, with particular emphasis on their clinical presentations, associated complications and both upper and lower airway abnormalities. The management options and outcome of these patients will also be discussed.
    Matched MeSH terms: Vocal Cord Paralysis/congenital; Vocal Cord Paralysis/diagnosis*; Vocal Cord Paralysis/surgery
  5. Asha'ari ZA, Razali MS, Ahmad RA
    Malays J Med Sci, 2010 Apr;17(2):56-60.
    PMID: 22135539
    Bilateral vocal cord palsy is almost always caused by neck surgery, particularly surgery of the thyroid. We report a case of bilateral vocal cord palsy requiring emergency surgery to relieve the airway obstruction as the sole presentation of acquired syphilis. As the incidence of syphilis worldwide is rising, this unusual presentation may give clinicians a different perspective on the disease.
    Matched MeSH terms: Vocal Cord Paralysis
  6. Latiff ZA, Kamal NA, Jahendran J, Alias H, Goh BS, Syed Zakaria SZ, et al.
    J Pediatr Hematol Oncol, 2010 Jul;32(5):407-10.
    PMID: 20505534 DOI: 10.1097/MPH.0b013e3181e01584
    Vincristine-induced vocal cord paralysis is a rare but serious complication. We report 2 patients with acute lymphoblastic leukemia who developed progressive stridor during induction chemotherapy. There were no clinical features of peripheral or autonomic neuropathy. Flexible laryngoscopy confirmed the diagnosis of bilateral vocal cord palsy; interestingly, the nerve conduction test revealed axonal motor neuropathy involving the median and common peroneal nerves in both patients. The first patient required prolonged ventilatory support necessitating unilateral cordectomy before extubation, whereas the second only required supplemental oxygen therapy. There was resolution of stridor in the first patient after cordectomy and gradual clinical improvement in the second. These cases illustrate that a high index of suspicion of vincristine-induced vocal cord palsy with prompt otolaryngology consultation for laryngoscopy is required in the diagnostic evaluation of a patient who has received vincristine.
    Matched MeSH terms: Vocal Cord Paralysis/chemically induced*; Vocal Cord Paralysis/drug therapy
  7. Munshi A, Pandey MB, Kumar L, Karak AK, Mohanti BK
    Med J Malaysia, 2006 Mar;61(1):97-9.
    PMID: 16708743
    Malignancy is the most common cause of tracheoesophageal fistulas. The malignancies commonly implicated in the development of tracheoesophageal fistulas are primary bronchial or esophageal carcinomas. Hodgkins disease rarely leads to such a fistula. We report a case of Hodgkin's disease with a tracheoesophageal fistula as well as a left recurrent nerve palsy at presentation. This presentation has no precedent in literature. The patient was treated with systemic chemotherapy and involved field radiotherapy. On follow up 1 year after the completion of treatment, he was clinically and radiologically disease free.
    Matched MeSH terms: Vocal Cord Paralysis/diagnosis*; Vocal Cord Paralysis/physiopathology
  8. Prepageran N, Raman R
    Med J Malaysia, 2005 Aug;60(3):377-8.
    PMID: 16379198
    Radiotherapy is the accepted treatment for early laryngeal carcinomas with the advantage of voice preservation. It is however, not without complications. We report a case of bilateral vocal cord immobility 15 years after radiotherapy. This appears to be due to ankylosis of cricoarytenoid joint and fibrosis of the larynx.
    Matched MeSH terms: Vocal Cord Paralysis/etiology*; Vocal Cord Paralysis/pathology*
  9. Indudharan R, Win MN, Noor AR
    J Laryngol Otol, 1998 Jan;112(1):81-2.
    PMID: 9538454
    Organophosphorous poisoning causing isolated laryngeal paralysis has only been rarely reported before. We describe a case of difficult extubation in a patient with organophosphorous poisoning, the cause of which was found to be bilateral vocal fold palsy. This is a type of intermediate paralysis that recovers with time. Such a condition should be thought of as a cause of dyspnoea or difficult extubation in patients with organophosphorous poisoning.
    Matched MeSH terms: Vocal Cord Paralysis/chemically induced*; Vocal Cord Paralysis/drug therapy
  10. Chen IHK, Remli R, Azman M, Ubaidah MA, Mohamed AS, Baki MM
    Auris Nasus Larynx, 2021 Dec;48(6):1140-1149.
    PMID: 33896673 DOI: 10.1016/j.anl.2021.03.028
    OBJECTIVE: Laryngeal electromyography (LEMG) is used to confirm neuropathy; traditionally, it is evaluated qualitatively. This study aimed to develop normative values for the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex by determining the mean turns (MT) and mean amplitudes (MA) using the opposite normal mobile vocal fold in unilateral vocal fold paralysis (VFP). This study also compared the MT and MA of the paralyzed vocal fold with that of the normal side and analyzed their correlations.

    METHODS: This is a cross-sectional study in which 77 patients (18 males, 59 females, mean age of 48) with unilateral VFP with an opposite normal mobile vocal fold underwent LEMG with a standardized protocol. Koufman gradings and MT and MA were used for the qualitative and quantitative evaluations. Mann-Whitney U test was performed to compare the median of the turns and amplitudes between the opposite normal mobile vocal fold and the paralyzed side. A linear-scale graphical "cloud" of the normal TA-LCA muscle complex was generated using logarithmic regression analysis. The qualitative and quantitative parameters were analyzed using multiple analysis of variance and Kruskall-Wallis test. Post-hoc analysis was performed to further determine the differences of the significance between both parameters. The correlation between the qualitative and quantitative parameters was analyzed using Spearman correlation.

    RESULTS: The MT and MA were significantly higher for the normal TA-LCA muscle complex than the paralyzed side (582 vs. 336; 412 vs. 296, respectively) and the median of the turns and amplitudes were significantly lower in the paralyzed side with p-values <0.001. A significant difference was observed between the Koufman grading and the combination of MT and MA [F (8,144) = 73.254] and between the Koufman grading and MT and MA individually [H (4, 72) = 18.3 and H (4, 72) =33.4], in which both had p-values <0.001. A moderate negative linear relationship was seen between the Koufman grading and MT and MA. On further analysis, it was revealed that only certain pairs of Koufman grading were statistical significant.

    CONCLUSIONS: This study was the first to present the quantitative normative values and "cloud" of the TA-LCA muscle complex using the opposite normal mobile vocal fold in patients with unilateral VFP in which it is comparable to healthy controls. We concluded that quantitative LEMG supports the qualitative Koufman grading method however it cannot be used independently to determine the severity of neuropathy.

    Matched MeSH terms: Vocal Cord Paralysis/diagnosis; Vocal Cord Paralysis/physiopathology*
  11. Johari SF, Azman M, Mohamed AS, Baki MM
    J Laryngol Otol, 2020 Dec;134(12):1085-1093.
    PMID: 33308327 DOI: 10.1017/S0022215120002558
    OBJECTIVE: To evaluate voice intensity as the primary outcome measurement when treating unilateral vocal fold paralysis patients.

    METHODS: This prospective observational study comprised 34 newly diagnosed unilateral vocal fold paralysis patients undergoing surgical interventions: injection laryngoplasty or medialisation thyroplasty. Voice assessments, including maximum vocal intensity and other acoustic parameters, were performed at baseline and at one and three months post-intervention. Maximum vocal intensity was also repeated within two weeks before any surgical interventions were performed. The results were compared between different time points and between the two intervention groups.

    RESULTS: Maximum vocal intensity showed high internal consistency. Statistically significant improvements were seen in maximum vocal intensity, Voice Handicap Index-10 and other acoustic analyses at one and three months post-intervention. A significant moderate negative correlation was demonstrated between maximum vocal intensity and Voice Handicap Index-10, shimmer and jitter. There were no significant differences in voice outcomes between injection laryngoplasty and medialisation thyroplasty patients at any time point.

    CONCLUSION: Maximum vocal intensity can be applied as a treatment outcome measure in unilateral vocal fold paralysis patients; it can demonstrate the effectiveness of treatment and moderately correlates with self-reported outcome measures.

    Matched MeSH terms: Vocal Cord Paralysis/diagnosis; Vocal Cord Paralysis/surgery*
  12. Jaafar R, Mohamad I
    Malays Fam Physician, 2014;9(1):25-7.
    PMID: 25606294 MyJurnal
    Unilateral vocal cord palsy secondary to thoracic aortic aneurysm is a rare occurrence. Direct compression of the enlarging thoracic aneurysm on the left recurrent laryngeal nerve causes neuronal injury of the nerve, which is manifested as hoarseness. We present a rare case of unilateral vocal cord palsy in a 60-year-old healthy gentleman caused by a large thoracic aortic aneurysm. This rare presentation, with a serious underlying pathology might be misdiagnosed or delayed. Therefore, it is important for us to have high index of suspicion in cases with a rare presentation such as this.
    Matched MeSH terms: Vocal Cord Paralysis
  13. Farah Nazlia Che Kassim, Muthusamy, Hariharan, Vijean, Vikneswaran, Zulkapli Abdullah, Rokiah Abdullah
    Voice pathology analysis has been one of the useful tools in the diagnosis of the pathological voice, as the method is non-invasive, inexpensive, and can reduce the time required for the analysis. This paper investigates feature extraction based on the Dual-Tree Complex Wavelet Packet Transform (DT-CWPT) using energy and entropy measures tested with two classifiers, k-Nearest Neighbors (k-NN) and Support Vector Machine (SVM). Massachusetts Eye and Ear Infirmary (MEEI) voice disorders database and Saarbruecken Voice Database (SVD) were used. Five datasets of voice samples were used from these databases, including normal and abnormal samples, Cysts, Vocal Nodules, Polyp, and Paralysis vocal fold. To the best of the authors’ knowledge, very few studies were done on multiclass classifications using specific pathology database. File-based and frame-based investigation for two-class and multiclass were considered. In the two-class analysis using the DT-CWPT with entropies, the classification accuracy of 100% and 99.94% was achieved for MEEI and SVD database respectively. Meanwhile, the classification accuracy for multiclass analysis comprised of 99.48% for the MEEI database and 99.65% for SVD database. The experimental results using the proposed features provided promising accuracy to detect the presence of diseases in vocal fold.
    Matched MeSH terms: Vocal Cord Paralysis
  14. Mohamad I, Jihan WS, Mohamad H, Abdullah B
    Malays J Med Sci, 2008 Jan;15(1):42-3.
    PMID: 22589614
    Bilateral abductor vocal cord palsy is comparatively a rare vocal cord lesion, especially in a patient with no history of neck mass, previous surgery or trauma. Many patients are not stridulous. A patient presenting with stridor may need emergency airway management before the other treatment is commenced. We report a case of bilateral abductor palsy which required an emergency tracheostomy and subsequently a laser posterior cordectomy.
    Matched MeSH terms: Vocal Cord Paralysis
  15. Tun M, Salekan K, Sain AH
    Malays J Med Sci, 2003 Jan;10(1):86-9.
    PMID: 23365506 MyJurnal
    From 1996 to 2001, 393 thyroidectomies were performed and 25 (6.4%) patients underwent reoperative thyroid surgery at Hospital Universiti Sains Malaysia. All reoperated patients had undergone one prior thyroid operation. All were females with an average age of 39.1 years (18-61 years). The most frequent indication for reoperation was cancer in resected specimen of an originally misdiagnosed carcinoma treated by partial thyroid resection. Final histological diagnosis of 25 reoperations showed thyroid carcinoma in 22 (88%) cases and multinodular goiter in 3 cases. The overall interval between the initial and the reoperative procedures ranged from 3 weeks to 15 years. There was no post-operative mortality after reoperation. Post-operative complications were discovered in 5 patients, as 3 (12%) of whom had transient hypocalcaemia, one (4%) had wound breakdown and one (4%) had permanent recurrent laryngeal nerve palsy. Reoperative thyroid surgery is an uncommon operation with high complication rate.
    Matched MeSH terms: Vocal Cord Paralysis
  16. Ab Rani A, Azman M, Ubaidah MA, Mohamad Yunus MR, Sani A, Mat Baki M
    J Voice, 2021 May;35(3):487-492.
    PMID: 31732294 DOI: 10.1016/j.jvoice.2019.09.017
    OBJECTIVE: This study compared the voice outcomes of selected patients with unilateral vocal fold palsy (UVFP) who underwent either nonselective laryngeal reinnervation (LR) or Type 1 thyroplasty (thyroplasty) in a Malaysian tertiary centre using multidimensional voice assessments.

    PARTICIPANTS: The study included 16 patients with UVFP who underwent either LR (9 patients) or thyroplasty (7 patients) between 2015 and 2018 who fulfilled the inclusion criteria.

    MAIN OUTCOME MEASURES: The outcomes were measured subjectively and objectively with: (1) voice handicap index-10 (VHI-10- Malay version); (2) auditory perceptual evaluation using the breathiness component of Grade, Roughness, Breathiness, Asthenia, Strain scale; (3) maximum phonation time (MPT); and (4) acoustic analysis (jitter%, shimmer%, and NHR) using OperaVOXTM. The outcomes were measured at baseline, 6 and 12-months postoperative. The comparison of outcomes between pre and postoperative of each group was evaluated using one-way ANOVA test. Mann-Whitney test was used to compare the outcomes between the two groups.

    RESULTS: Comparison of each group at different time points showed significant improvement of VHI-10 and MPT of LR group between baseline and 12 months (P ≤ 0.05) whereas, the improvement in thyroplasty group was observed at all time points (P ≤ 0.05). When comparing between the two groups at 12 months, the VHI-10 and MPT was significantly better in the LR group than thyroplasty group with P = 0.004 and P = 0.001 respectively. Other outcome measures did not reveal significant difference between the two groups.

    CONCLUSION: This observational study showed that LR may be better than thyroplasty in improving VHI-10 and MPT in selected patients with UVFP.

    Matched MeSH terms: Vocal Cord Paralysis
  17. Norly, S., Noorizan, Y., Ros’aini, P.
    We present a case of 80-year-old man with two-year history of hoarseness of voice secondary to left vocal cord paralysis. CT scanning revealed a saccular thoracic aneurysm compressing the left recurrent laryngeal nerve. A review of literature on Ortner's or cardiovocal syndrome is presented.
    Matched MeSH terms: Vocal Cord Paralysis
  18. Misron K, Balasubramanian A, Mohamad I, Hassan NF
    BMJ Case Rep, 2014;2014.
    PMID: 24663247 DOI: 10.1136/bcr-2013-201033
    Bilateral vocal cord paralysis is a known possible complication following thyroid surgery. It owes to the close relationship between the recurrent laryngeal nerve and the thyroid gland. The most feared complication of bilateral vocal cord paralysis is airway compromise. We report the case of a 39-year-old woman who underwent total thyroidectomy for multinodular goitre. The surgery was uneventful. However she developed stridor in the recovery bay needing intubation. We postulate that the cause was attributed to bilateral vocal cord paresis due to the use of the intraoperative nerve monitoring (IONM) whose high setting throughout the surgery was overlooked. She made a complete recovery without the need of a tracheostomy. We share our lessons learnt from this case.
    Matched MeSH terms: Vocal Cord Paralysis/etiology*
  19. Irfan M, Shahid H, Baharudin A, Friedrich G
    Med J Malaysia, 2009 Mar;64(1):89-90.
    PMID: 19852333 MyJurnal
    Vocal cord palsy secondary to recurrent laryngeal nerve injury may be attributable to trauma, infiltrating neoplasm, congenital cardiac anomaly and others. Regardless the causes, majority of unilateral adductor palsy cases are usually managed by speech rehabilitation in order to allow compensation. In selected cases, medialization procedure may be required to achieve a complete glottal closure during phonation. Multiple techniques have been developed to achieve this goal. This case report illustrates the recent advancement in vocal fold medialization procedure, which has not been widely practiced in Malaysia.
    Matched MeSH terms: Vocal Cord Paralysis/surgery*
  20. Alazzawi S, Hindi K, Malik A, Wee CA, Prepageran N
    Laryngoscope, 2015 Nov;125(11):2551-2.
    PMID: 26108861 DOI: 10.1002/lary.25422
    We describe extremely rare cases of vocal cord palsy following surgical insertion of a chemo port. Our cohort consisted of patients with cancer who developed hoarseness immediately after central venous line placement for the administration of chemotherapy, with vocal cord palsy confirmed with flexible laryngoscopy. Given the timing, central venous line placement appears to be the most likely cause.
    Matched MeSH terms: Vocal Cord Paralysis/etiology*
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links