Statistical Analysis of Malignant Tumors Detected as the Cause of Vocal Cord Paralysis

Abstract

It is well known that vocal cord paralysis is sometimes the only sign of an otherwise symptom-free malignant tumor. We report 69 cases of vocal cord paralysis caused by malignant tumor experienced at our clinic over the past 18 years. They consisted of 28 cases of thyroid cancer, 21 lung cancer, 14 esophageal cancer, 3 mediastinal tumors and 3 tumors of miscellaneous origin: 41 cases were male and 28 female. In the 65 patients with unilateral paralysis, the left side was affected in 45 and the right in 20. The remaining 4 patients had bilateral paralysis. There was a marked sex difference in the origin of malignant tumors; the incidence of lung cancer was higher in males with paralysis on the left side, while that of thyroid cancer was higher in females. Ultrasonography (US) of the neck, chest X-ray, CT scan of the chest and contrast esophagography should be performed for the detection of malignant tumors in cases with left paralysis, while US of the neck and chest X-ray appear to be sufficient in cases of right paralysis.

CT Evaluation of Vocal Cord Paralysis due to Thoracic Diseases: A 10-Year Retrospective Study

“…VCP has been reported to be about 1.4-2.5 times more frequent on the left side than on the right 3. In our cases diagnosed with a thoracic disease, left-side VCP was 1.75 times more frequent than right-side VCP.…”

“…The other three were associated with right-side paralysis, and the CT scan detected one case of right apical lung carcinoma and two cases of metastatic nodes in the right upper paratracheal region. Masaki, et al suggested that neck ultrasonography and chest X-rays were a sufficient evaluation modality for patients with right VCP 3. But in our study, CT was needed in a patient with a small right apical lung carcinoma that was hidden behind rib shadows, and also in a patient with VCP caused by phlebitis and right upper mediastinitis during use of an intravenous chemo port (an implantable port for chemotherapy).…”

“…For males, when no primary malignancy is found on the CT scans, contrast esophagography or esophagoscopy is recommended to examine the possibility of esophageal cancer 3. Esophagoscopy has the advantage of tissue visualization and biopsy.…”

“…It is sometimes the only sign of an underlying disease 2. Thus, it is clinically important to diagnose the primary disease in cases of vocal cord paralysis (VCP) because many of its potential causes, such as symptom-free malignant tumors, can be fatal or cause serious morbidity if detected late 2,3. Radiologic evaluation is often useful for determining the etiology of VCP, especially for conditions within the thoracic cavity.…”

Paralisia unilateral de prega vocal: associação e correlação entre tempos máximos de fonação, posição e ângulo de afastamento

“…As controvérsias iniciam-se pela caracterização das diferentes posições assumidas pela PVP. De acordo com a posição assumida, estas podem ser classificadas em mediana, para-mediana, intermediária e em abdução completa ou cadavérica 17 . Esta é uma descrição clássica, rotineiramente empregada na clínica médica.…”