反回神経麻痺症例の臨床的観察

概要

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A review was made on one hundred clinical cases of recurrent laryngeal nerve palsy who visi-ted the Voice and Speech Clinic of the Depart-ment of Otorhinolaryngology, University of Tokyo, during the past four years and eight months.There was no significant difference in sex ratio and a survey of age distribution showed a peak at the third decade of life. The causes of palsy were; thyroidectomy in 32, diseases and surgery on the neck other than thyroidectomy in 10, intratho-ratic surgery in 12, chest diseases in 9, associated laryngeal palsy in 9, postoperative complication other than chest and neck surgery in 4 and idio-pathic in 24, respectively.A discussion was made on the problem of the position of paralyzed cord especially from the view point of electromyographic study. The au-thors were agreeable neither with Semon-Rosen-bachs theory nor with Wagner-Grossmanns and considered that the overall balance of the tonus of muscles relating to vocal cord movement would play an important role in deciding the position of the prarlyzed cord.The authors also made a long term follow-up of dysphonic cases and observed that approxima-tely 40% of the cases showed improvement in breathy character of voice within one year.Further discussion was made on therapeutic approaches and significance of voice therapy inc-luding pushing exercise was stressed. Indication and technique of mediofixation operation was pre-sented based on our experience in 10 cases.