Etiology of Vocal Cord Paralysis

Abstract

Objective: Vocal cord paralysis (VCP) is a sign of a certain underlying disease, a diagnosis which can be attributed to various causes. This study intends to analyze the contemporary etiology of VCP in a tertiary medical center. Materials and Methods: A retrospective review of medical records from June 2000 to December 2004 of hospitalized patients with VCP was done to determine the etiology. Results: Two hundred and ninety-one patients with a determined etiology were identified, consisting of 176 males and 115 females. Unilateral VCP was present in 259 patients, while 32 presented with bilateral VCP. The causes were surgical in 40.2%, neoplastic in 29.9%, idiopathic in 10.7%, traumatic in 8%, central in 3.8%, radiation-induced in 3.4%, inflammatory in 2%, cardiovascular in 1.7% and other causes in 0.3% of the cases. Thyroidectomy represented the most common surgery for VCP and was the cause in 57 patients. Lung cancer was responsible for 34 cases and was the most common neoplastic etiology. In males, neoplasm was the most common cause occurring in 63 of 176 males, whereas surgery was most frequent in 59 of 115 females. Conclusion: Surgical trauma, mainly thyroidectomy, is the most common cause of VCP in hospitalized patients. The possibility of a neoplasm must be ruled out before VCP is labeled idiopathic. A benign thyroid tumor could also cause VCP. Besides, radiation-induced cranial nerve paralysis in head and neck cancer may play a significant role.

Computational fluid dynamics in the assessment of patients' postoperative status after glottis-widening surgery

“…Consequently, the opening became asymmetrical, which led to some minor differences in velocities for the same areas of the opening. Again, for areas below about 40 mm 2 , there is a visible increase in the maximum velocity, albeit less pronounced than in the case of ΔP. For areas between 20 and 40 mm 2 , wmax increased from 2.5 to 5 m/s.…”

“…It was determined that resistance to airflow, expressed as the pressure drop ΔP, depends on the area of the glottic opening and is virtually independent of its shape. During free breathing, a steep rise in ΔP occurs for areas below about 40 mm 2 . It can be concluded that below this area even a minor enlargement of the glottis may significantly improve quality of breathing.…”

“…It is a symptom of bilateral damage to the recurrent laryngeal nerve (RLN), which is responsible for the mobility of the abductor and adductor muscles of the glottic space. 2,3 The most common cause of RLN damage is surgical intervention in either the neck or the chest (thyroid gland, cardiac and thoracic surgical procedures). 2,4 Shortness of breath, especially during the inspiratory phase, is a symptom accompanying BVFP, which can be concurrent with stridor and hoarseness.…”

“…2,3 The most common cause of RLN damage is surgical intervention in either the neck or the chest (thyroid gland, cardiac and thoracic surgical procedures). 2,4 Shortness of breath, especially during the inspiratory phase, is a symptom accompanying BVFP, which can be concurrent with stridor and hoarseness. 5 Some patients adapt quickly to diminished glottic space, while others require immediate tracheotomies followed by glottis-widening surgery.…”

Unilateral Vocal Cord Paralysis Following High Oesophageal Stricture Dilatation: Case Report and Review of the Literature

“…However, there are four major causes: surgery, malignancy, idiopathic and neck trauma. Previous studies, such as those performed by Chen and Ko, have demonstrated that thyroidectomy is the most common surgical cause of vocal cord paralysis, followed by cardiac surgery [7,8]. There have only been two reported cases of vocal cord paralysis following oesophageal stenting or dilatation procedures.…”