J Korean Soc Laryngol Phoniatr Logoped.  2016 Dec;27(2):130-133. 10.0000/jkslpl.2016.27.2.130.

A Case of Bilateral Vocal Fold Paralysis Induced by Concurrent Rheumatoid Arthritis Involvement of Laryngeal Nerve and Cricoarytenoid Joint

• Park YH
• Kim HS
• Jung SM
• Jung SY

• KMID: 2369123
• DOI: http://doi.org/10.0000/jkslpl.2016.27.2.130

Abstract

Rheumatoid arthritis (RA) is a connective tissue disease involving the larynx in 30% of the patients. Foreign body sensation, hoarseness, and cough are common symptoms in laryngeal involvement. An urgent tracheostomy is required when acute airway obstruction occurs in case of bilateral vocal fold paralysis. The most common cause of bilateral vocal fold paralysis in RA patients is a cricoarytenoid joint arthritis. Laryngeal nerve degeneration is rare cause of bilateral vocal fold paralysis in RA patients. In this case report, an emergent tracheostomy was performed on a 64-years-old male patient with acute dyspnea, and concurrent involvement of RA on laryngeal nerve and cricoarytenoid joint was revealed by laryngeal electromyography and histopathology. The vocal fold mobility was restored after 3-months medical treatment.

Keyword

Rheumatoid arthritis; Vocal fold paralysis; Neuropathy; Cricoarytenoid joint

MeSH Terms

Airway Obstruction
Arthritis
Arthritis, Rheumatoid*
Connective Tissue Diseases
Cough
Dyspnea
Electromyography
Foreign Bodies
Hoarseness
Humans
Joints*
Laryngeal Nerves*
Larynx
Male
Paralysis*
Sensation
Tracheostomy
Vocal Cords*