International Journal of Phonosurgery & Laryngology

Register      Login

VOLUME 1 , ISSUE 1 ( January-June, 2011 ) > List of Articles

RESEARCH ARTICLE

Unilateral Vocal Cord Palsy: An Etiopathological Study

Citation Information : Unilateral Vocal Cord Palsy: An Etiopathological Study. Int J Phonosurg Laryngol 2011; 1 (1):5-10.

DOI: 10.5005/jp-journals-10023-1002

Published Online: 01-06-2014

Copyright Statement:  Copyright © 2011; The Author(s).


Abstract

Objective

The incidence of various causes of unilateral vocal cord palsy (UVCP) has been found to change over time and place. To arrive at the correct diagnosis is important in determining the prognosis as well as the time and mode of intervention. This study intends to evaluate the current etiological profile of unilateral vocal cord palsy in our center and compare it with the previous studies.

Methods

A retrospective study of case records of all consecutive patients with a diagnosis of UVCP presented to Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, South India in the period between September 2002 and May 2009 was conducted. The exclusion criteria were all laryngeal and hypopharyngeal malignancies, intubation injuries and cricoarytenoid joint ankylosis. Factors taken for analysis were age, gender, side of palsy and etiology.

Results

A total of 121 cases including 88 males and 33 females in the age range of 2 to 86 years were studied. 61.1% patients had left-sided palsy and 38.8% had right-sided palsy. The incidence of various etiologies were idiopathic (42.1%), surgical trauma (22.3%), nonsurgical trauma (6.61%), nonlaryngeal malignancy (6.61%), central (12.4%) and other benign lesions (9.09%). The incidence of all nonthyroidectomy surgeries together (59.3%) was more than that of thyroidectomy (40.7%). The most common individual surgical procedure was still thyroidectomy (11 cases, 40.7%) followed by coronary artery bypass grafting (CABG) (7 cases, 25.9%).

Conclusion

Idiopathic vocal cord palsy constituted the major subgroup. Thyroidectomy continues to be the single most common surgical procedure responsible for vocal cord palsy. Cardiac surgeries, trauma and cerebrovascular accidents are also increasingly causing vocal cord palsy, which is suggestive of the changing trend in life style and life expectancy. The right recurrent laryngeal nerve is not at higher risk than the left in thyroid surgery. Benign thyroid swellings also contribute significantly to UVCP.


PDF Share
  1. Recurrent laryngeal nerve paralysis: Anatomy and etiology. Otolaryngol Clin N Am 2004;37:25-44.
  2. Vocal fold paralysis: Causes, outcomes and clinical aspects. Vocal fold paralyses 2006.
  3. Causes of recurrent laryngeal nerve paralysis. Auris Nasus Larynx 2002;29:41-45.
  4. Recurrent laryngeal nerve paralysis. A 10 year review of 564 patients. Auris Nasus Larynx 1983;10(Suppl):S1-15.
  5. Vocal fold immobility: A longitudinal analysis of etiology over 20 years. Laryngoscope 2007;117:1864-70.
  6. Etiologic features in patients with unilateral vocal fold paralysis in Taiwan. Chang Gung Med J 2009;32:290-96.
  7. Changing etiology of vocal fold immobility. Laryngoscope 1998;108:1346-49.
  8. Paresis of the vagus and accessory nerve in the course of the herpes zoster. Otolaryngol Pol 2006;60(4): 611-14.
  9. Isolated vagus nerve palsy probably associated with herpes simplex virus infection. Acta Neurol Scand 2001;104(3):174-77.
  10. Simultaneous vocal fold and tongue paresis secondary to Epstein-Barr virus infection. Head-Neck Surgery 2000;126(12):1491-94.
  11. Temporary multiple cranial nerve palsies in a patient with type I diabetes mellitus. Diabetes Metab 2002;28:413-16.
  12. The cause and evaluation of unilateral; vocal cord paralysis. J Med Assoc Thai 2001;84:855-58.
  13. Vocal fold paralysis after open heart surgery. Eur J Cardiothoracic Surg 2002;21:671-74.
  14. Vocal cord palsy as a complication of adult cardiac surgery: Surgical correlations and analysis. Eur J Cardiothoracic Surg 2004.
  15. Is dysphonia permanent or temporary after anterior cervical approach? Eur Spine J 2007;16:2092-95.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.