Complaints of patients with unilateral and bilateral motion disorders of the larynx

Relevance: In the structure of diseases of the vocal apparatus, paresis and paralysis of the larynx make up a significant share. The most common cause of peripheral paresis and paralysis of the larynx is surgical trauma to the laryngeal nerves during operations, primarily due to thyroid gland diseases. A stable trend towards an increase in the number of patients with thyroid neoplasms, an indicator of the prevalence of thyroid cancer among the population of Ukraine after the accident at the Chernobyl nuclear power plant, causes an increase in the number of patients with paralytic laryngeal stenosis in our country. Despite the improvement of surgical methods of treatment of diseases of the thyroid gland, a significant decrease in the number of patients with paresis and paralysis of the larynx is not observed. The purpose of the study: to study the complaints of patients with unilateral and bilateral motor disorders of the larynx. Materials and methods: Examined: 55 patients with bilateral movement disorders of the larynx (group 1); 51 patients with bilateral movement disorders of the larynx after applied surgical treatment, namely endoscopic unilateral chordoaryte noidotomy (group 2); 24 persons with unilateral movement disorders of the larynx (group 3). During the survey, both complaints of a local nature, from the vocal apparatus, and general complaints were evaluated - those that can reflect the general state of the body, primarily of the cardiovascular and central nervous systems. Results: In the examined patients with motor disorders of the larynx, complaints were most often found, which indicated a change in sonority, strength and timbre of the voice, in particular, hoarseness of varying degrees of severity, disruption of "sound", narrowing of the range, decrease in voice sonority. In particular, 66.7% of examined patients with unilateral paresis (group 3) complained of moderate hoarseness, 25% of them noted minor hoarseness, and 8.3% - pronounced hoarseness. In 1 group of patients with bilateral motor disorders of the larynx before chordoarytenoidotomy, 60.0% defined hoarseness as moderate, 23.6% as pronounced, and 16.4% as insignificant. However, after surgical treatment (group 2 – patients with bilateral paresis and paralysis of the larynx after chordoarytenoidotomy), an increase in the number of patients with pronounced hoarseness was determined to 53.0% of cases, and the number of patients in this group who complained of minor hoarseness was only 9.8 %. 54.5% of people in the first group, 74.5% in the second group, and 75.0% in the third group complained about "voice fatigue". In the first group, 70.9% of patients had a "disruption" of sound, in the second group - 64.7%, in the third - 50.0%, respectively. Many patients characterized the voice as one that "sits down" closer to the evening, noted the deterioration of the quality of the voice in humid and warm weather. 32.7% of people in the first group and 50% of people in the third group noted a narrowing of the range and a change in the loudness of the voice, and in the second group, as many as 94.1% of patients complained about a narrowing of the range. A change in the sonority of the voice was noted by 86.3% of people from the second research group. During the survey of patients with bilateral paralysis of the larynx (group 1), complaints were noticed, which were described by 18 patients (32.7%) as "absence of laughter", "dull laughter", "distorted crying and laughter", conscious restriction of laughter and crying. It should be noted that no other group of patients raised such complaints. 8 patients of the first group (14.5%), 7 patients of the third group (29.2%) and 5 patients of the second group (9.8%) noted periodic dusting with liquid, rarely solid food. So, among the patients of group 1, among the local complaints, the following were most often: voice failure (70.9%), moderate hoarseness (60.0%), and a feeling of discomfort and "lump" in the throat (36.3%). In the 2nd group, narrowing of the voice range (94.1%), change in voice sonority (86.3%), and voice fatigue (74.5%) were most often observed. In patients of group 3, such complaints as voice fatigue (75%), pain and muscle tension (66.9%), and moderate hoarseness (66.7%) came to the fore. In all 3 groups, patients noted headache and increased irritability, memory impairment among the leading complaints. And the patients in group 1 in a significant percentage of cases were also bothered by heaviness in the head. Also, in this group, many patients experienced dizziness (56.3%), while in group 2, only 33% experienced dizziness, and in group 3, there was none at all. Therefore, patients with movement disorders of the larynx, both unilateral and bilateral, present a significant number of complaints of both local and general nature. Moreover, in some of these complaints there is practically no difference between the groups - such as the feeling of a "balloon", voice fatigue. While other complaints vary considerably in frequency from group to group. This applies to such complaints as pronounced hoarseness, narrowing of the voice range, pain and tension in the neck muscles, dizziness, heaviness in the head. Conclusions: 1. In patients with movement disorders of the larynx, it is advisable to analyse both local and general complaints. 2. In patients with bilateral paresis and paralysis of the larynx, the most complaints reflect insufficiency of respiratory function, and as a result - hypoxia. After surgical treatment, complaints about voice function become dominant in such patients. In patients with unilateral paresis and paralysis, the voice function and disorders of the regulation of the larynx activity suffer the most, which is due, among other things, to its asymmetry in such cases. 3. The analysis of complaints of patients with movement disorders of the larynx is expedient to use in diagnosis and planning of treatment and rehabilitation measures.