Vocal cord paralysis in the Shy-Drager syndrome.

TLDR

Shy‑Drager syndrome frequently presents with snoring, inspiratory and expiratory stridor, and sometimes sleep apnea. In a cohort of 12 patients, 8 exhibited severe bilateral vocal‑cord abduction paresis, and tracheostomy reversed respiratory failure in 4 cases and alleviated severe sleep apnea in another, showing that this complication can occur even in early disease and that timely intervention can extend life.

Abstract

Eight out of 12 unselected patients with Shy-Drager syndrome were found to have severe bilateral paresis of vocal cord abduction by fibre-optic laryngoscopy. This commonly presented as increased snoring followed by episodes of inspiratory and expiratory stridor and sometimes by sleep apnoea. Respiratory failure eventually developed in four cases and was reversed by tracheostomy. In another patient tracheostomy relieved severe attacks of sleep apnoea. This complication was not necessarily associated with advanced disease, and it should be considered in all patients with Shy-Drager syndrome as appropriate treatment can lead to a useful extension of life.