Effect of Hyaluronic Acid Injection for a Dysphagia Patient Who Has Unilateral Vocal Fold Paralysis due to a Lateral Medullary Infarction: A Case Report
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This paper reports a case of a female patient aged 48 years diagnosed with a right lateral medullary infarction anddysphagia after the onset period. In a video fluoroscopic swallowing study (VFSS), significant manifestations werenot observed in the oral phase, but during swallowing aspiration, a larger amount of post-swallowing residue wereobserved on the test of swallowing of semisolid and liquid. After the VFSS, a laryngoscopy was performed, whichindicated paralysis and para-median fixation in the right vocal fold. In this case, swallowing with rightward headrotation was adopted as a compensation technique to reduce the aspiration caused by the para-median fixation ofthe right vocal fold, but it was not enough to improve the dysphagia in this case. To medialize the right vocalfold, hyaluronic acid was injected with laryngoscopic guidance. In a VFSS conducted after the injection, aspirationwas not observed on the test of swallowing a semisolid and liquid. The injection of hyaluronic acid is less invasivethan surgical operations, does not require general anesthesia, and makes the recovery time shorter. Therefore, it isexpected to be an alternative to the treatment of unilateral vocal fold paralysis (UVFP) accompanied withdysphagia.
Abstract
This paper reports a case of a female patient aged 48 years diagnosed with a right lateral medullary infarction anddysphagia after the onset period. In a video fluoroscopic swallowing study (VFSS), significant manifestations werenot observed in the oral phase, but during swallowing aspiration, a larger amount of post-swallowing residue wereobserved on the test of swallowing of semisolid and liquid. After the VFSS, a laryngoscopy was performed, whichindicated paralysis and para-median fixation in the right vocal fold. In this case, swallowing with rightward headrotation was adopted as a compensation technique to reduce the aspiration caused by the para-median fixation ofthe right vocal fold, but it was not enough to improve the dysphagia in this case. To medialize the right vocalfold, hyaluronic acid was injected with laryngoscopic guidance. In a VFSS conducted after the injection, aspirationwas not observed on the test of swallowing a semisolid and liquid. The injection of hyaluronic acid is less invasivethan surgical operations, does not require general anesthesia, and makes the recovery time shorter. Therefore, it isexpected to be an alternative to the treatment of unilateral vocal fold paralysis (UVFP) accompanied withdysphagia.
참고문헌 (14)
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