We report a case of granulomatous lesion infiltrating the recurrent laryngeal nerve to produce vocal cord palsy, the diagnostic dilemma posed by it and its management.

Clinical documentation of a 52-yearold man who presented with hoarseness of 3 months duration is presented. The clinical examination revealed immobile left vocal cord and a bulky (Lt) ventricular band with a suspicious ulcer on its posterior aspect. A computed tomographic (CT) scan of the neck and chest revealed a 1 × 1 cm nodular lesion in the tracheoesophageal groove.

Causes for vocal cord palsies are wide ranging and predominantly include malignant infiltration of the vagus or the recurrent laryngeal nerve. The anatomical site of involvement can be clinically and radiologically assessed with ease. Vocal cord palsy due to recurrent laryngeal nerve involvement by a granulomatous lesion is an unreported phenomenon and we believe that this is the first case to be reported in literature.

An unusual case of recurrent laryngeal nerve granuloma is reported with the diagnostic dilemma that it presented. This was successfully managed by surgical excision and postoperative antituberculosis treatment.

Varghese BT, Sebastian P, Divya GM. An Unusual cause for Vocal Cord Palsy: Case Record. Int J Phonosurg Laryngol 2012;2(2):88-90.