Laryngeal paralysis (laryngeal paresis): diagnosis
Last reviewed: 23.04.2024
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The high incidence of paralysis of the larynx of tumor nature dictates the need for careful examination of patients with the purpose of detecting malignant neoplasms. When assessing anamnesis pay attention to the duration of the disease, because this affects the tactics of treatment.
Laboratory research
Conduct a general clinical examination.
Instrumental research
All patients with larynx paralysis of unknown origin receive the examination according to the following algorithm:
- X-ray or computed tomography of the larynx and trachea;
- X-ray or computed tomography of the thorax and mediastinum;
- Radiography of the esophagus with contrasting with a solution of barium sulfate, which can be supplemented with endofibroesophagoscopy;
- Ultrasound of thyroid gland, consultation of endocrinologist;
- CT of the brain in the presence of neurologic symptoms or with suspected central paralysis, a neurologist's consultation.
The clinical and functional state of the larynx is determined by the parameters of the function of external respiration, micro-laryngoscopy and micro-laryngostroscopy of acoustic voice analysis. Apply electromyography and glottography.
Differential diagnostics
In the one-sided paralysis of the larynx, differential diagnosis is performed with the immobility of the vocal fold due to the pathology of the percutaneous papular joint, including dislocation, subluxation, arthritis and ankylosis. The sign of dislocation is the lack of symmetry of the joints, the presence of signs of inflammation in the joint region, displacement of the arytenoid cartilage and the restriction of mobility or complete immobility of the vocal fold on the side of the lesion. Arthritis is characterized by swelling and hyperemia of the mucosa in the region of the joint.
Differential diagnostics of the pathology of the metatarsal spine is carried out with the help of X-ray or computed tomography by means of which the region of the pericothetical articulation is well visualized; but by electromyography; The definition of electromagnetic resonance, reflecting the state of internal spaces between soft tissues. The most informative method is the endolaryngeal sounding probe joint.
Indications for consultation of other specialists
When conducting differential diagnosis of paralysis of an unclear genesis, consultations of the endocrinologist, neurologist, pulmonologist are shown.
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