PRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 98 No. 10 October 2005
Dysphagia with Chronic Obstructive Pulmonary
Disease and Vocal Cord Palsy: A Case Report
Takao Ogawa, Masakazu Hanamitsu, Masahiko Arikata,
Satoshi Seno, Mikio Suzuki and Takeshi Shimizu
(Shiga University of Medical Science)
A 67-year-old man was admitted for vocal cord paralysis and dysphasia. He was suffering from dyspnea attack on aspiration in addition to his chronic obstructive pulmonary disease (COPD). Expansion of the piriform recess by videofluorography suggested vagus nerve palsy. We failed with conservative treatment but succeeded with operative treatment. We performed thyroplasty, adduction of arytenoid cartilage and bilateral dissection of cricopharyngeal muscle in a two-phase operation. The dissection of contralateral cricopharyngeal muscle was especially effective. We suspected the cricopharyngeal muscle of the diseased side had no systole. Tube nutrition was discontinued without dyspnea attack. In the literature, COPD brings potential dysphagia, and so we thought that in this case severe dysphagia occurred after the vocal cord palsy.
Key words : dysphagia, chronic obstructive pulmonary disease, aspiration pneumonia, dissection of the cricopharyngeal muscle, vocal cord palsy