A 20 year-old male was admitted to our hospital on May 6th, 1959 complaining of a sudden onset of inspiratoric dyspnea. As the vocal cord was seen to be paralysed in the bilateral midline abductor, an emergency tracheotomy was performed.
While the patient was in the hospital, etiology of the bilateral midline abductor paralysis was not determined even after complete physical, radiographic and laboratory studies. Our suspicions of tuberculous laryngitis were, however, confirmed under indirect laryngoscopy and streptomycin was injected for about 4: 0 days. As a result of these injections a remission was noted, and he was discharged and sent as an out patient to one of the otolaryngologists near his residence for further observation.
The patient was readmitted to our hospital on March 22nd, 1960 as he was suffering from bleeding an enormous amount from his nose, mouth and tracheotomy opening. He died on March 29th, 1960 in spite of intensive treatment such as blood and fluid transfusions, hemostats, etc.
According to a complete autopsy a typical visceral tuberculosis was seen, which may have been developed by lymphogenous dissemination.
We concluded that the bilateral midline abductor paralysis had been caused by a partial paralysis of the inferior laryngeal nerve (Xth cranial nerve) around the upper portion of trachea and mediastinum, probably due to a remarkable swelling of the lymph nodes.
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