Dysphagia due to Bilateral Recurrent Laryngeal Nerve Injury after Attempted Suicide by Hanging: A Case Report
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Survival from an attempted suicide by hanging is associated with various complications. However, the development of dysphagia after an attempt of suicidal hanging has not been widely reported in literature. Here, we report a case of a 17-year-old teenager who presented with dysphagia after an attempted suicide by hanging. Computerized tomography (CT), magnetic resonance imaging (MRI), and endoscopic examination confirmed no evidence of central lesions or injury to the vocal cords or larynx. A motor nerve conduction study suggested bilateral recurrent laryngeal nerve injuries. In this case, vocal cord paralysis and dysphagia were attributable to the compression of the recurrent laryngeal nerves by a cord wrapped around the neck. We adopted dysphagia rehabilitation approaches such as the Shaker exercise and the Mendelsohn maneuver. Improvements were observed in a subsequent videofluoroscopic swallowing study, fiberscope finding, and motor nerve conduction study. These were consistent with clinical improvement. In conclusion, recurrent laryngeal nerve injuries can be caused by attempted hanging and hence evaluation for dysphagia is needed in survivors of hanging incidents.
Abstract
Survival from an attempted suicide by hanging is associated with various complications. However, the development of dysphagia after an attempt of suicidal hanging has not been widely reported in literature. Here, we report a case of a 17-year-old teenager who presented with dysphagia after an attempted suicide by hanging. Computerized tomography (CT), magnetic resonance imaging (MRI), and endoscopic examination confirmed no evidence of central lesions or injury to the vocal cords or larynx. A motor nerve conduction study suggested bilateral recurrent laryngeal nerve injuries. In this case, vocal cord paralysis and dysphagia were attributable to the compression of the recurrent laryngeal nerves by a cord wrapped around the neck. We adopted dysphagia rehabilitation approaches such as the Shaker exercise and the Mendelsohn maneuver. Improvements were observed in a subsequent videofluoroscopic swallowing study, fiberscope finding, and motor nerve conduction study. These were consistent with clinical improvement. In conclusion, recurrent laryngeal nerve injuries can be caused by attempted hanging and hence evaluation for dysphagia is needed in survivors of hanging incidents.
참고문헌 (8)
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