특발성 일측성 성대마비에서 경구 스테로이드 요법의 효과
The Effect of Steroid Therapy for Idiopathic Unilateral Vocal Cord Palsy
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Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient’s dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.
Abstract
Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient’s dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.
참고문헌 (14)
- Anil HT, "A study on etiopathogenesis of vocal cord paresis and palsy in a tertiary centre", Indian J Otolaryngol Head Neck Surg, 71(3), pp.383~389 (2019)
- Masroor F, "The incidence and recovery rate of idiopathic vocal fold paralysis : a population-based study", Eur Arch Otorhinolaryngol, 276(1), pp.153~158 (2019)
- Rasmussen ER, "Vocal cord paralysis associated with Ramsay Hunt syndrome: looking back 50 years", BMJ Case Rep, 2014, pp.bcr2013201~ (2014)
- Rubin F, "Idiopathic unilateral vocal-fold paralysis in the adult", Eur Ann Otorhinolaryngol Head Neck Dis, 135(3), pp.171~174 (2018)
- Kwon M, "Idiopathic unilateral vocal fold paralysis in older patients : characteristics in the disease course and implication of computed tomography for evaluation of etiology", Ann Otol Rhinol Laryngol, 127(11), pp.823~828 (2018)
- Bhatt NK, "Association between upper respiratory infection and idiopathic unilateral vocal fold paralysis", Ann Otol Rhinol Laryngol, 127(10), pp.667~671 (2018)
- Cantarella G, "A retrospective evaluation of the etiology of unilateral vocal fold paralysis over the last 25 years", Eur Arch Otorhinolaryngol, 274(1), pp.347~353 (2017)
- Hojjat H, "Cost-effectiveness of routine computed tomography in the evaluation of idiopathic unilateral vocal fold paralysis", Laryngoscope, 127(2), pp.440~444 (2017)
- Tibbetts KM, "Etiology and long-term functional swallow outcomes in pediatric unilateral vocal fold immobility", Int J Pediatr Otorhinolaryngol, 88, pp.179~183 (2016)
- Chang WH, "Quantitative electromyographic characteristics of idiopathic unilateral vocal fold paralysis", Laryngoscope, 126(11), pp.E362~E368 (2016)
- Spataro EA, "Etiology and time to presentation of unilateral vocal fold paralysis", Otolaryngol Head Neck Surg, 151(2), pp.286~293 (2014)
- Reiter R, "Prognostic relevance of mucosal waves in patients with unilateral vocal fold paralysis", Ann Otol Rhinol Laryngol, 125(4), pp.331~335 (2016)
- Francis DO, "Effect of injection augmentation on need for framework surgery in unilateral vocal fold paralysis", Laryngoscope, 126(1), pp.128~134 (2016)
- Mau T, "The natural history of recoverable vocal fold paralysis : implications for kinetics of reinnervation", Laryngoscope, 127(11), pp.2585~2590 (2017)