Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-02T20:37:21.773Z Has data issue: false hasContentIssue false

Dural metastasis at medulla oblongata: a rare cause of vocal fold paralysis

Published online by Cambridge University Press:  29 June 2007

Martin Wai Pak
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, Hong Kong.
Henry Ka Fung Mak
Affiliation:
Department of Diagnostic Radiology, Queen Mary Hospital, Hong Kong.
Peter Ka Ming Ku
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, Hong Kong.
Charles Andrew van HasseltS*
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, Hong Kong.
*
Address for correspondence: Professor C. A. van Hasselt, Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, New Territories, Hong Kong. Fax: (852) 2646 6312

Abstract

Malignancy is a major cause of vocal fold paralysis. Nevertheless, metastatic disease at the brainstem leading to high vagal paralysis is rarely encountered. We illustrate an unusual case of unilateral vocal fold paralysis caused by dural metastasis directly compressing on the nucleus ambiguus. The median position of the paralysed vocal fold is inconsistent with the Wagner and Grossman theory predicting the location of the lesion.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Atlas, S. W. (1991) Magnetic Resonance Imaging of the Brain and Spine. 1st Edition. Raven, New York, pp 311318.Google Scholar
Clerf, L. H., Suehs, O. W. (1941) Paralysis of the larynx. Annals of Otology, Rhinology and Laryngology 50: 762.CrossRefGoogle Scholar
David, J. W., Philip, M. S. (1991) Vocal cord paralysis. In Otolaryngology Volume III, 3rd Edition. (Paparella, M. M., Shumrick, D. A., Gluckman, J. L., Meyerhoff, W. L., eds.) W. B. Saunders Company, Philadelphia, pp 22892306.Google Scholar
Davis, P. C, Hudgins, P. A., Peterman, S. B., Hoffman, J. C. (1991) Diagnosis of cerebral metastases: double dose delayed CT vs contrast-enhanced MR imaging. American Journal of Neuroradiology 12(2): 293300.Google ScholarPubMed
FitzGerald, M. J. T. (1985) Neuroanatomy Basic and Applied. 1st edition. Balliere Tindall, New York, pp 248250.Google Scholar
Garcia, M. (1881) Transactions of the Section of Laryngology of the Vllth International Congress of Medicine 3: 197.Google Scholar
Grossman, M. (1987) Experimentelle Beitrage zur Lehre von der ‘Posticuslahmung’. Archiv fur Laryngologie und Rhinologie 6: 282.Google Scholar
Posner, J. B., Chernik, N. L. (1978) Intracranial metastases from systemic cancer. Advances in Neurology 19: 579592.Google ScholarPubMed
Quiney, R. E., Michaels, L. (1990) Histopathology of vocal cord palsy from recurrent laryngeal nerve damage. Journal of Otolaryngology 19(4): 237241.Google ScholarPubMed
Semon, F. (1881) Clinical remarks on the proclivity of the abductor fibres of the recurrent laryngeal nerve to become affected sooner than the adductor fibres, or even exclusively, in cases of undoubted central or peripheral injury or disease of the roots or trunks of the pneumogastric, spinal accessory or recurrent nerves. Archives of Laryngology 2: 197.Google Scholar
Stell, P. M., Maran, A. G. D. (1978) Head and Neck Surgery 2nd Edition. William Heinemann Medical Books, London, pp 194204.Google Scholar
Sze, G., Soletsky, S., Bronen, R., Krol, G. (1989) MR imaging of the cranial meninges with emphasis on contrast enhancement and meningeal carcinomatosis. American Journal of Neuroradiology 10(5): 965975.Google ScholarPubMed
Wagner, R. (1890) Die Medianstellung der Stimmbander bei der Rekurrenslahmung, Archiv fur pathologische Anatomie and Physiologi 210: 124, 127; 4378.Google Scholar
Weir, N. (1990) The Age of Scientific Subdivision: Laryngology and Rhinology. Otolaryngology: An Illustrated History 1st edition. Butterworth Scientific, London, pp 102147.Google Scholar
Wyke, B. D., Kirschner, J. A. (1976) Larynx-neurology. In Scientific Foundations of Otolaryngology. William Heinemann Medical Books, London, pp 546574.Google Scholar