A case of dysphagia and vocal impairment due to hypertrophic pachymeningitis caused by granulomatosis with polyangiitis

Abstract

We herein report a case of dysphagia and voice impairment due to granulomatosis with polyangiitis (GPA) complicated with hypertrophic pachymeningitis. The patient experienced vagal paralysis and consequently displayed midline fixation of the vocal cords and collateral and compensatory muscle tension dysphonia, resulting in breathing and vocal hoarseness. One year after the onset, surgery was performed to adjust the vocal cord position. However, the patient's voice self-feedback and pitch adjustment were poor, and the hypertonic dysphonia remained. Voice function improvement surgery and voice treatment were performed, resulting in improved muscle tone and vocalization. In addition, the patient's subjective impression improved as well. We showed that voice therapy can improve the quality of life of affected patients if GPA disease symptoms are remitted.