Glottic dyskinesia
Introduction
Introduction Glottic dyskinesia is a type of disorder in which the glottic motor function is abnormal due to various causes and the clinical manifestation is vocal dysfunction. Can be divided into four types of neurological, muscular, joint and functional. Neurological glottic dyskinesia is caused by recurrent laryngeal nerve spasm, and abnormal laryngeal nerve spasm is rare. Laryngeal diaphragmatic dyskinesia is rare, such as myasthenia gravis. Joint glottic dyskinesia is caused by ring ankle arthritis or ring ankle joint fixation. Rheumatoid and rheumatoid arthritis are the main causes. Non-infectious arthritis, such as gout and other collagen diseases, can be associated with ankle joint. inflammation. Functional glottic dyskinesia is mostly caused by mental factors.
Cause
Cause
First, neurological glottic dyskinesia: caused by the recurrent laryngeal nerve spasm, the laryngeal nerve spasm is rare.
Second, laryngeal glottic dyskinesia: rare, such as myasthenia gravis.
Third, joint glottic dyskinesia: caused by ring ankle arthritis or ring ankle joint fixation, rheumatism, rheumatoid as its main cause, there are non-infectious arthritis, such as gout and other collagen diseases, can be accompanied Ring ankle arthritis.
Fourth, functional glottic dyskinesia: mostly caused by mental factors.
Examine
an examination
Related inspection
Otolaryngology CT examination of nasopharyngeal MRI
Signs:
First, neurological glottic dyskinesia:
1, caused by recurrent laryngeal nerve spasm, unilateral sputum is more common, one side of the ring sacral muscle, the diaphragmatic sacral muscle and the nail muscle loss function, the vocal cord is located in the paracentral position, can not be abducted or inward, sound When the door is closed, it has a triangular triangle, and the patient is vocal and has a leaky feeling. A few months later, due to the compensatory effect of the healthy side vocal cords, the healthy side vocal cords transcended the midline during the pronunciation, which relieved the symptoms and improved the pronunciation. Bilateral recurrent laryngeal nerve spasm, except for the ring muscle, the other two laryngeal muscles were paralyzed, and the two vocal cords were in the median position, causing severe breathing difficulties, and immediate tracheotomy should be performed.
2, laryngeal nerve spasm: unilateral sex can make one side of the tendon tendon, due to the contraction of the healthy side of the ring muscle, the anterior glottis can be skewed to the healthy side, the affected side of the vocal cord is slack, resulting in weak pronunciation, tone Thick and low, can't make a high pitch. If the nerves on both sides of the throat are paralyzed, the glottic fissure is incompletely closed, the pronunciation is low and leaking, and there is a mistake.
Second, laryngeal glottic dyskinesia: light type, only the pronunciation is weak, the sound is low and weak, the glottis is incomplete, easy to fatigue. In severe cases, the clinical manifestations are aphasia, dysphagia, and eating and drinking, which is prone to lung infection.
Third, joint glottic dyskinesia: mild ring ankle arthritis, the main symptoms are throat foreign body sensation, sore throat and hoarseness. Long-term ankle arthritis can cause the ankle joint to be fixed. One side can be fixed with hoarseness, and both sides can have aphasia and difficulty breathing.
Fourth, functional glottal dyskinesia: rare, the patient's expression is slow, the hands and feet are numb, aphasia.
Medical examination:
First, laryngeal glottic dyskinesia: laryngoscopy: light can be seen in the vocal cords bow, heavy vocal activity is slow or inactive, and can not even cough.
Second, joint glottic dyskinesia: mild sputum arthritis under the laryngoscope see mild congestion of the ankle, vocal cord closure or abduction slightly restricted. Long-term laryngeal arthritis laryngoscopy can be seen on one or both sides of the vocal cords fixed in the midline or in the middle position, with the probe palpation of the movement of the ankle, whether it is joint fixation or vocal cord paralysis.
Third, functional glottic dyskinesia: laryngoscopy see the bilateral vocal cords in a quiet breathing state, and soon can return to normal.
Diagnosis
Differential diagnosis
The diagnosis should be differentiated from the following symptoms:
1. Damage above the glottis: Damage above the glottis is a clinical manifestation of open neck injury. Dislocation of the sacral cartilage and hemorrhage of the glottis or glottis also have hoarseness or loss of sound, and sometimes throat lary occurs when inhaling. Patients often complain of swallowing pain, difficulty swallowing, coughing, and unable to turn the head.
2. glottic edema: refers to the glottic mucosal edema, erosion and submucosal bleeding. Mostly caused by external factors.
