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Introduction: Chemotherapy is a rare cause of iatrogenic vocal fold dysfunction. It has been reported in three main classes of chemotherapy agents and often occurs during the treatment interval. We present a case of bilateral vocal cord paresis with delayed presentation after completion of chemotherapy. Methods: One case, managed with observation and serial exams, is presented. A review of previous case reports of chemotherapy-induced vocal cord paresis and possible mechanisms of injury was performed. Results: Patient improved both symptomatically and through objective findings over the one-year course of observation. Conclusion: Diagnosis of chemotherapy-induced vocal cord paresis is dependent on a thorough history and physical exam. Management is predicated in that the dysfunction is often dose dependent and reversible, necessitating both cessation of the offending agent and the knowledge that any treatment is likely needed for only a temporary time. Chemotherapy-induced vocal fold paresis should be in the differential for patients presenting with hoarseness, dysphonia, stridor and a positive chemotherapy history.

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Objective: This anatomic study considers the feasibility of a posterior endoscopic approach to the cricoarytenoid joint (CAJ) by describing relationships between readily identifiable anatomic landmarks and the posterior CAJ space in cadaver larynges. Study Design: Anatomic study. Methods: Six adult cadaver larynges (2 male, 4 female) were studied. Digital calipers were used for measurements, and Image J software was used for angle calculations. All cricoarytenoid joints were injected with colored gel via a posterior approach using a 27-gauge needle. Results: The average age of the larynges studied was 78.7 ± 10 years. The average posterior CAJ space (pCAJs) length measured 4.95 ± 0.9 mm. The average distance from the superior aspect of the midline cricoid lamina (MCL) to the center of pCAJs and the corniculate cartilage (CC) to the center of the pCAJs were 8.35 ± 1.5 mm and 14.54 ± 1.9 mm, respectively. The average pCAJs angle of declination (AD) from the horizontal plane was 54° ± 6.2°. All 12 cricoarytenoid joints were successfully injected with colored gel via a posterior approach. Conclusions: The posterior CAJ space can be located surgically using readily identifiable anatomic landmarks. An understanding of this posterior CAJ anatomy may allow for more consistent intra-articular injection and support the development of other CAJ procedures for a range of disorders of vocal fold motion or malposition.