Review article
https://doi.org/10.26332/seemedj.v1i1.38
Vocal Cord Paralysis and Parathyroid Cyst
Davorin Đanić
; Department of Ear, Nose and Throat, Head and Neck Surgery, “Dr Josip Benčević” General Hospital, Slavonski Brod; Department of Ear, Nose and Throat and Maxillofacial Surgery, Osijek School of Medicine, Josip Juraj Strossmayer University in Osijek, Osijek,
Ljubica Fuštar Preradović
; Pathology and Cytology Laboratory, “Dr Josip Benčević” General Hospital, Slavonski Brod, Croatia
Rajko Jović
; Clinical Department of Ear, Nose and Throat, Clinical Center Vojvodina, Novi Sad, Serbia
Ana Đanić Hadžibegović
; Department of Ear, Nose and Throat, Head and Neck Surgery, “Dr Josip Benčević” General Hospital, Slavonski Brod; Department of Ear, Nose and Throat and Maxillofacial Surgery, Osijek School of Medicine, Josip Juraj Strossmayer University in Osijek, Osijek,
Abstract
Aim: Parathyroid gland lesions are an extremely rare clinical entity, mostly manifesting as adenoma and hyperplasia, rarely as parathyroid cysts, and most infrequently as carcinoma. Parathyroid cysts are frequently asymptomatic lesions of the neck and the superior mediastinum with only 300 cases reported in the literature. Symptomatic parathyroid cysts are very rare. Vocal cord paralysis due to recurrent laryngeal nerve dysfunction may herald the presence of neck and mediastinal disease including a variety of neoplastic, inflammatory and vascular conditions. The aim of this report is to describe their clinical presentation, diagnostic procedures, and therapeutic approaches. The objective of the study was to assess the presence of vocal cord paralysis and recurrent laryngeal nerve dysfunction, as well as their association in patients with recurrent laryngeal nerve.
Methods. We performed a 12-year departmental review of parathyroid lesions and parathyroid cysts. Retrospective analysis of clinical data on 20630 unselected patients submitted to thyroid gland and neck ultrasonography yielded 149 (0.007%) patients with parathyroid lesions, six (0.0003%) of them with parathyroid cysts. A comprehensive review of the literature revealed 18 patients with vocal cord paralysis and parathyroid cysts.
Results: Parathyroid adenoma were present in 97/149 (0.65%) and hyperplasia in 46/149 (0.30%) patients with parathyroid lesions. Parathyroid cysts were present only in six of 149 (0.04%) patients with parathyroid lesions. Five patients had asymptomatic nonfunctional parathyroid cysts, with vocal cord paralysis diagnosed in one female patient. In the 19 patients with parathyroid cysts and vocal cord paralysis reported in the literature (including the patient reported here), nine and ten patients had parathyroid cysts localized in the neck and mediastinum, respectively. Mediastinal cysts were twofold greater than those localized on the neck, while left recurrent laryngeal nerve dysfunction was recorded in 80% of cases. Cyst removal resulted in recurrent laryngeal nerve functional recovery in two-thirds of patients.
Conclusion: Parathyroid cysts are rare, mostly asymptomatic pathologic lesions of parathyroid glands that should be taken into consideration in patients with hyperparathyroidism or vocal cord paresis.
Keywords
Parathyroid lesion; Cyst; Vocal cord; Paralysis; Cytology
Hrčak ID:
186759
URI
Publication date:
3.7.2017.
Visits: 1.032 *