vocal cords & RA

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I found the following on-line when I did a search for vocal cords & RA. This

actually seems more like what I have. I have neck pain & the laryngitis. I don't

know how common this would be or how serious...

Tricia

Cervicomedullary Compression: An Unrecognized Cause Of Vocal Cord Paralysis In

Rheumatoid Arthritis

Dana Link, MD, MS, V. McCaffrey, MD, PhD,

E. Krauss, MD, J. Link, MD, M. Troy Ferguson, MD

Cervicomedullary compression (CMC) from traumatic, infectious, or congenital

processes of the atlanto-axial joint is a known cause of vocal cord immobility.

Cervicomedullary compression can also occur from destructive arthritic changes

and inflammatory pannus formation at the occipito- atlanto- axial joint in

patients with rheumatoid arthritis (RA).

We present findings suggesting that CMC in patients with RA is an unrecognized

cause of vocal cord immobility. Previously, vocal cord immobility in patients

with RA has been assumed to be cricoarytenoid arthritis with joint fixation. We

report 3 patients with RA and radiographically demonstrated CMC with vocal cord

immobility. One patient had bilateral vocal cord immobility and airway

obstruction; 2 patients had unilateral cord paralysis and contralateral paresis

without airway compromise. All patients had myelopathy and neck pain in addition

to brain stem symptoms. All patients underwent trans oral-transpharyngeal

decompression of the anterior craniocervical junction with subsequent posterior

fusion. These patients demonstrated full return of vocal cord function within 3

months of decompression. We propose that CMC is a cause of vocal cord paralysis

in patients with RA that may go unrecognized without appropriate imaging studies

of the skull base and

physician awareness of symptoms of occipito-atlanto-axial subluxation and/or

basilar invagination with brain stem compression. Our results demonstrate that

CMC in RA is a potentially reversible cause of vocal cord paralysis.

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