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E cord.   there is also associated loss of sensation in the supraglottic area causing subtle symptoms like frequent throat clearing, paroxysmal coughing, voice fatigue and foreign body sensation in the throat. Bilateral superior laryngeal nerve injury:  fortunately this condition is very rare.   it could result in fatal aspiration and pneumonia.   this condition is infact difficult to diagnose as there is no asymmetry between the vocal folds. buy viagra Unilateral recurrent laryngeal nerve injury: is the most common situation encountered.   left cord is affected commonly than the right as the left vagus nerve takes a more tortuous course.   to start with the voice is breathy, but the normal vocal cord starts to compensate soon. generic viagra canada   the air way is adequate and there is no stridor in these patients.   on indirect laryngoscopic examination the affected cord could assume any of the 6 positions described above. viagra testimonials forums   the cord may appear not to move, while the opposite cord will compensate for the lack of mobility. viagra testimonials forums   when right vocal cord is paralysed then tuberculosis or bronchial malignancies should be considered to be a possibility. use viagra side effect viagra   left vocal cord is involved in oesophageal malignancies, and in viral infections. Unilateral superior and recurrent laryngeal nerve injury: this occurs usually in high vagal or brain stem lesions. viagra canada   vocal folds are in intermediate position and the patient tends to have a breathy voice.   there is also a tendency to aspirate. Bilateral recurrent laryngeal nerve palsy:  in this condition both cords assume a paramedian position compromising the airway.   this commonly occurs following total thyroidectomy or in thyroid malignancies. buy liquid viagra women   the patient will commonly manifest with stridor. buy viagra without prescription   the voice will be near normal. Bilateral superior and recurrent laryngeal nerve injury: bilateral vocal cords are intermediate, flaccid, and motionless. viagra online   the patient experiences aphonia and is at high risk for aspiration. viagra viagra trial pack Evaluation: the standard diagnostic workup and evaluation of a patient with vocal cord paralysis of unknown etiology is as follows:   cxr, cervical spine series, barium swallow, thyroid scan, ct or mri of head, neck, and possibly thorax, cbc, thyroid function tests, esr, rheumatoid factor, parathyroid hormone, calcium and glucose levels, ppd, vdrl, fungal titers, lyme titers, and possibly a lumbar puncture.        another adjuvant diagnostic aid to be considered is laryngeal electromyography.   described by miller et al in 1982, this method of evaluation of laryngeal muscle innervation is graduall. viagra generic viagra 100mg tablets LMC Events
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