A Bilateral Abductor Palsy Due to Radiotherapy in Supraglottic Cancer – A Case Report

Abstract

Radiotherapy is an established mode of treatment for head and neck cancer. Radiotherapy associated with bilateral abductor palsy of the vocal fold is one of the rarest causes. Bilateral abductor palsy of the vocal folds is a serious condition that can be life-threatening. Timely and precise diagnosis is essential, followed by urgent treatment. There are different causes of bilateral abductor cord paralysis, with iatrogenic trauma post-thyroidectomy surgery being the most common cause. Treatment always aims to achieve two primary goals including establishing a clear airway and maintaining the function of the glottic sphincter while ensuring good voice quality. Multiple treatment options are available for bilateral abductor vocal fold paralysis, including arytenoidectomy, cordotomy, lateral fixation of the vocal fold, reinnervation procedures, and botulinum toxin injection. Here, we report a case involving a 65-year-old man with a prior history of supraglottic carcinoma who had received radiotherapy treatment 5 years ago. He arrived at the emergency department presenting with stridor. The patient was treated surgically by using coblation-assisted posterior cordotomy.