Idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2
Objectives: Neurofibromatosis 2 (NF2) is an autosomal dominant condition presenting with bilateral vestibular schwannomas and other neural tumors. Vocal fold paralysis (VFP) in NF2 patients is typically due to compression of the vagus nerve at the cerebellopontine angle (CPA) or vagal injury during...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Otolaryngology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468548820300321 |
| _version_ | 1828554693130846208 |
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| author | Aaron Tverye Joe Walter Kutz Kathleen M. Tibbetts |
| author_facet | Aaron Tverye Joe Walter Kutz Kathleen M. Tibbetts |
| author_sort | Aaron Tverye |
| collection | DOAJ |
| description | Objectives: Neurofibromatosis 2 (NF2) is an autosomal dominant condition presenting with bilateral vestibular schwannomas and other neural tumors. Vocal fold paralysis (VFP) in NF2 patients is typically due to compression of the vagus nerve at the cerebellopontine angle (CPA) or vagal injury during tumor surgery. Idiopathic VFP in these patients has not been reported. Methods: Case series. Results: A 15 year old female with NF2 presenting with dyspnea and dysphonia was found to have left VFP and right vocal fold paresis narrowing her glottic airway. She had no history of surgery for CPA tumors, and bilateral vestibular schwannomas were stable on imaging and not compressing the vagus nerves. Symptoms improved with voice and respiratory retraining therapy. She remains under close observation and may require surgical intervention to relieve glottic airway obstruction should her right vocal fold become immobile.A 14-year-old male with NF2 presenting with new onset dysphonia was found to have left VFP. He had undergone surgery for a right facial neuroma and right eye enucleation 7 years prior. His left CPA tumors were stable on imaging and not compressing the vagus nerve. He has undergone two in-office injection laryngoplasties and voice therapy with improvement in dysphonia. He will be a candidate for medialization thyroplasty as an adult if his right vocal fold remains mobile. Conclusions: Currently there are no reports of idiopathic VFP in patients with NF2. Given these patients’ young age and the progressive nature of NF2, they are managed with temporary interventions and observation. |
| first_indexed | 2024-12-12T05:40:18Z |
| format | Article |
| id | doaj.art-b6fdaebe941c4605aec75a726d4e3556 |
| institution | Directory Open Access Journal |
| issn | 2468-5488 |
| language | English |
| last_indexed | 2024-12-12T05:40:18Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Otolaryngology Case Reports |
| spelling | doaj.art-b6fdaebe941c4605aec75a726d4e35562022-12-22T00:35:56ZengElsevierOtolaryngology Case Reports2468-54882020-09-0116100187Idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2Aaron Tverye0Joe Walter Kutz1Kathleen M. Tibbetts2University of Texas Southwestern Medical Center, Department of Otolaryngology-Head and Neck Surgery, 2001 Inwood Road, Dallas, TX, 75235, USAUniversity of Texas Southwestern Medical Center, Department of Otolaryngology-Head and Neck Surgery, 2001 Inwood Road, Dallas, TX, 75235, USACorresponding author. University of Texas Southwestern Medical Center, Department of Otolaryngology-Head and Neck Surgery, 2001 Inwood Road, 7th Floor, Dallas, TX, 75235, USA.; University of Texas Southwestern Medical Center, Department of Otolaryngology-Head and Neck Surgery, 2001 Inwood Road, Dallas, TX, 75235, USAObjectives: Neurofibromatosis 2 (NF2) is an autosomal dominant condition presenting with bilateral vestibular schwannomas and other neural tumors. Vocal fold paralysis (VFP) in NF2 patients is typically due to compression of the vagus nerve at the cerebellopontine angle (CPA) or vagal injury during tumor surgery. Idiopathic VFP in these patients has not been reported. Methods: Case series. Results: A 15 year old female with NF2 presenting with dyspnea and dysphonia was found to have left VFP and right vocal fold paresis narrowing her glottic airway. She had no history of surgery for CPA tumors, and bilateral vestibular schwannomas were stable on imaging and not compressing the vagus nerves. Symptoms improved with voice and respiratory retraining therapy. She remains under close observation and may require surgical intervention to relieve glottic airway obstruction should her right vocal fold become immobile.A 14-year-old male with NF2 presenting with new onset dysphonia was found to have left VFP. He had undergone surgery for a right facial neuroma and right eye enucleation 7 years prior. His left CPA tumors were stable on imaging and not compressing the vagus nerve. He has undergone two in-office injection laryngoplasties and voice therapy with improvement in dysphonia. He will be a candidate for medialization thyroplasty as an adult if his right vocal fold remains mobile. Conclusions: Currently there are no reports of idiopathic VFP in patients with NF2. Given these patients’ young age and the progressive nature of NF2, they are managed with temporary interventions and observation.http://www.sciencedirect.com/science/article/pii/S2468548820300321Neurofibromatosis type 2Vocal fold paralysisNeurolaryngologyDysphoniaDyspnea |
| spellingShingle | Aaron Tverye Joe Walter Kutz Kathleen M. Tibbetts Idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2 Otolaryngology Case Reports Neurofibromatosis type 2 Vocal fold paralysis Neurolaryngology Dysphonia Dyspnea |
| title | Idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2 |
| title_full | Idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2 |
| title_fullStr | Idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2 |
| title_full_unstemmed | Idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2 |
| title_short | Idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2 |
| title_sort | idiopathic vocal fold paralysis in two adolescent patients with neurofibromatosis type 2 |
| topic | Neurofibromatosis type 2 Vocal fold paralysis Neurolaryngology Dysphonia Dyspnea |
| url | http://www.sciencedirect.com/science/article/pii/S2468548820300321 |
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