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Stemmebåndsparese - udredning og opfølgning

Læge Camilla Slot Mehlum, overlæge Christian Emil Faber, overlæge Ågot Møller Grøntved & overlæge Peter Andersen Odense Universitetshospital, Øre-næse-halskirurgisk Afdeling F og Røntgendiagnostisk Afdeling
Ugeskr Læger 2009;171(3):113-117
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Summary Vocal fold palsy - investigation and follow-up Ugeskr Læger 2009;171(3):113-117 Background: A new protocol for investigation of vocal fold palsy (VFP) was introduced in the ENT-department, Odense University Hospital on 1 January 2002. The protocol included ultrasonography (US) of the neck, x-ray of the chest and clinical examination at 3-month intervals for 1 year as well as MRI scanning of the brainstem, neck and mediastinum initially and after 6 months (or CT scanning under special circumstances). We have evaluated our protocol for investigation and in particular with regard to efficiency of diagnostic methods and the effect of long-term follow-up. Materials and methods: From 1 January 2002 to 30 June 2002 we investigated 48 patients with VFP of occult origin in our department. We reviewed medical records and registered and analyzed data regarding efficiency of diagnostic methods and the effect of follow-up. Results: Ten out of 48 VFP (21%) proved to be caused by malignancy. Eight VFP had other causes and 30 were idiopathic. Nine out of ten malignant diseases were found during initial investigation. One patient was diagnosed with breast cancer and widespread metastases 10 months after initial investigation. Conclusion: An extensive protocol for investigation of VFP is indicated. In our opinion, a protocol should include US, CT or MRI scanning of brainstem, neck and mediastinum. Our material is too limited to draw any final conclusions concerning long-term follow-up.
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