Dysphonia frequently occurs independently of throat pain due to nerve pathways
the verdict
INSUFFICIENT LEANING
refutedsupported
the weight of evidence
2 sources for · 0 against
The retrieved literature notes that neurological events and conditions can cause vocal symptoms and cranial nerve palsies, but it lacks direct studies establishing that dysphonia frequently occurs independently of throat pain strictly via specific nerve pathways.
Vocal symptoms are frequent in patients with coronavirus disease 2019 (COVID-19) and may occur during or after infection. To conduct a descriptive review on the topic "dysphonia and COVID-19" in order to alert specialists to these symptoms associated with the virus and sequelae. A literature review was carried out in the main databases: Web of Science, PubMed, Google Scholar, and Scopus, between April 2020 and April 2024 using descriptors that related COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) to voice disorders. In total, 41 studies, 13 case reports, 6 retrospective, and 22 prospective, 5139 patients (2131 M, 2991 F), mean age of 51 years. The prevalence of dysphonia ranged from 0.39% to 79%. The most prevalent vocal symptoms were hoarseness, cough, dry throat, sore throat, reflux, aphonia, phonasthenia, stridor, and hypersecretion. Videolaryngoscopic findings: unilateral paralysis (145), bilateral paralysis (16), erythema (84), benign lesions (56), muscle tension dysphonia (54), granulomas (33), edema (31), stenosis (22), atrophy (19), incomplete glottal closure (12), and ventricular hypertrophy (6). Auditory-perceptual analyses identified mild/moderate vocal impairment in infected patients and persistence of changes in the long-COVID period. Acoustic analyses indicated significant changes in Jitter, Shimmer, harmonic-to-noise ratio (NHR), and maximum phonation time in patients with COVID-19. Dysphonia caused by COVID-19 infection is common, both in the acute and chronic phases of the disease. The main causes include vocal fold paralysis, inflammatory laryngitis, and muscle tension dysphonia. All patients who present vocal symptoms after COVID-19 infection should undergo videolaryngoscopy and subjective and acoustic vocal analyses to identify sequelae of the disease.
Spontaneous dissection of the cervical internal carotid artery. Presentation with lower cranial nerve palsies.
Spontaneous dissections of the internal carotid arteries are uncommon but are not rare. They constitute a fairly common cause of ischemic stroke in young patients (young in terms of the age at which strokes generally occur). The common presenting manifestations are (1) unilateral headaches followed after a period of delay by focal cerebral ischemic symptoms or (2) unilateral headaches and ipsilateral incomplete Horner's syndrome. These may or may not be associated with subjective or objective bruits. In rare instances, spontaneous dissections of the internal carotid arteries may present as lower cranial nerve palsies and cause dysphonia, dysarthria, dysphagia, and numbness of the throat. Affected patients may initially present to the otolaryngologist or be referred to one. This article describes eight patients with spontaneous dissections of the internal carotid arteries and lower cranial nerve palsies, and the pertinent literature is reviewed.
Published in Archives of otolaryngology--head & neck surgery (1992)
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