Abductor Paresis in Shy–Drager Disease
Vocal cord abductor paralysis (VCAP) is one of the life-threatening complications in multiple system atrophy. We proposed the mechanism as a multifactorial process, involving paralytic, nonparalytic, and enhancing factors. VCAP is diagnosed by both clinical features, including nocturnal inspiratory stridor with severe oxygen desaturation, and laryngofiberscopic examination showing paradoxical vocal cord movement. While a tracheostomy has been exclusively applied for VCAP in the past, noninvasive positive pressure ventilation has recently been used with some effectiveness. Of clinical importance is that the upper airway obstructions caused by the supraglottic tissues such as floppy epiglottis and floppy arytenoid are unresponsive to noninvasive positive pressure ventilation.
KeywordsVocal Cord Multiple System Atrophy Central Sleep Apnea Noninvasive Positive Pressure Ventilation Multiple System Atrophy Patient
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