A 15-year-old girl came to the emergency department (ER) at a Massachusetts General Hospital, United States (US), with symptoms of respiratory problems nine days after being diagnosed with Covid-19 infection. Endoscopic examination revealed bilateral vocal cord paralysis. Namely, immobility of the two vocal cords in the larynx or voice box.
The researchers concluded that this paralysis was likely a downstream effect of the Covid-19 virus when extensive examination found no other cause. Doctors and researchers from Mass Eye and Earmember Mass General Brighamreported it as the first case of bilateral vocal cord paralysis in a child after Covid-19 infection.
The case was presented on Tuesday (19/12/2023) in the Journal Pediatrics. This case shows that vocal cord paralysis may be a complication of viruses related to the nervous system (neuropathic), in addition to neurological complications that are common in children and adults.
“Given how common this virus is in children, this newly recognized potential complication should be considered in any child who experiences breathing, speaking, or swallowing complaints following a recent diagnosis of Covid-19. “This is especially important because these complaints can easily be associated with more common diagnoses such as asthma,” said study author Danielle Reny Larrow, MD, a resident in the Department of Otolaryngology-Head and Neck Surgery at Mass Eye and Ear.
While in the hospital, patients underwent a series of detailed diagnostic tests from Mass General Brigham physicians, including blood tests, imaging, cerebrospinal fluid analysis and consultations with otolaryngology, neurology, psychiatry, speech-language pathology and neurosurgery experts.
When speech therapy failed to relieve the patient’s symptoms, doctors performed a tracheostomy – a surgically created hole in the throat – to relieve the patient’s breathing difficulties. However, the patient remained tracheostomy dependent for more than 13 months after initial treatment. That suggests that this type of nerve complication may not be temporary.
Doctors were able to remove the tracheostomy 15 months after its installation and just in time for the patient’s high school graduation and prom.
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2023-12-21 10:29:00
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