Laryngeal neuropathy of Charcot-Marie-Tooth disease: further observations and novel mutations associated with vocal fold paresis.
OBJECTIVE
To describe and define laryngeal neuropathy in Charcot-Marie-Tooth (CMT) disease.


METHODS
Retrospective record review from a university laryngology practice.


RESULTS
Four adult CMT patients presented with laryngeal symptoms. Three patients exhibited bilateral vocal fold palsy, in each case with more severe hypomobility on the left. One case exhibited an isolated left vocal fold palsy. All patients complained of hoarseness and stridor, three had dyspnea, two patients had dysphagia, and one had obstructive sleep apnea (OSA). One patient has required airway surgery to date. Genetic testing revealed known sequence alterations in one case and sequence alterations previously not associated with laryngeal dysfunction in two cases. One case was familial and two were sporadic; information is not available in a fourth.


CONCLUSIONS
The clinical course of the cases suggests slowly progressive neuropathy that appears to be nerve length dependent. The lack of severe respiratory distress despite dense bilateral paresis is consistent with existing reports and with the reported low rate of tracheostomy in adults with laryngeal manifestations of CMT. Genetic testing does not currently inform expectations or management of laryngeal disease. Dyspnea, dysphagia, and OSA symptoms in patients with CMT require careful laryngologic evaluation.
Benson
Brian
B
New York Center for Voice and Swallowing Disorders, St. Luke's Roosevelt Medical Center, New York, New York, USA.
Sulica
Lucian
L
Guss
Joel
J
Blitzer
Andrew
A
D000328:Adult; D002607:Charcot-Marie-Tooth Disease / Q000150:complications* / Q000235:genetics / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D049489:Stroboscopy; D014826:Vocal Cord Paralysis / Q000150:complications / Q000235:genetics* / Q000503:physiopathology