I'm trying to figure out if my breathlessness & rapid heart rate during exercise are related to my unilateral vocal cord paralysis and subsequent laryngeal framework surgery (medialization thyroplasty).
I thought my breathing problems during exercise would improve after the surgery, but they are the same or worse.
Anway, I found this article
Otolaryngol Head Neck Surg. 1999 Jun;120(6):819-23. Links |
Impact of laryngeal paralysis and its treatment on the glottic aperture and upper airway flow characteristics during exercise.Beaty MM, Hoffman HT.
University of Iowa Hospital, 200 Hawkins Drive, Iowa City, IA 52240, USA.
Patients with unilateral vocal fold paralysis occasionally report shortness of breath during exercise. This symptom may persist in some patients after medialization thyroplasty. A review of the literature revealed no study that objectively evaluated laryngeal dynamics or airway flow characteristics during exercise after medialization thyroplasty for unilateral laryngeal paralysis. This study evaluates glottic aperture size and configuration as well as upper airway flow characteristics during exercise in 16 subjects. Six patients who underwent medialization thyroplasty for unilateral vocal fold paralysis were compared with 10 healthy control subjects. During a standardized exercise protocol on an incremental ergometer (bicycle type), real-time videolaryngoscopy was obtained and correlated in a synchronized fashion with maximum-effort respiratory efforts at the beginning, midpoint, and end of the exercise period. Direct calculations of glottic size during various phases of the exercise period were performed from digitized images. These data were correlated with inspiratory flow data for each patient. Patients with laryngeal paralysis demonstrated smaller mean glottic areas and lower peak inspiratory flow rates than controls both at rest and during all phases of the exercise period. This study suggests that after treatment of unilateral laryngeal paralysis with medialization thyroplasty, inspiratory flow rate and glottic area are significantly less than in normal controls.
and am looking for the full text.
My doctor would be the usual source of information, but he hasn't been super helpful. I am a runner and in the past year, I've gone from being able to easily run 6-7 miles at a time at a 10min/mile pace to struggling to run 2-4 miles at an 11-12 minute pace, and when I do, my heart rate is well above 190.
I feel like this has to be related to the vocal cord, since the onset was about the same time, though the exercise/breathing/heart rate didn't get really bad until Januaryish.
Some more articles I can't read:
Multidimensional assessment of functional outcomes of medialization thyroplasty.
Eur Arch Otorhinolaryngol. 2005 Aug;262(8):616-21. Epub 2004 Dec 10.
Ann Otol Rhinol Laryngol. 1996 Apr;105(4):280-5.
Quantitative videostroboscopic measurement of glottal gap and vocal function: an analysis of thyroplasty type I.Omori K, Kacker A, Slavit DH, Blaugrund SM.
Longitudinal evaluation of vocal function after thyroplasty type I in the treatment of unilateral vocal paralysis.
Laryngoscope. 1996 May;106(5 Pt 1):573-7.
Long-term results of different treatment modalities for glottic insufficiency.
Am J Otolaryngol. 2008 Jan-Feb;29(1):7-12.
Sipp JA, Kerschner JE, Braune N, Hartnick CJ.
Laryngeal aerodynamics after vocal fold augmentation with autologous fat vs thyroplasty in the same patient.
Arch Otolaryngol Head Neck Surg. 2005 Aug;131(8):696-700.