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

Abstract

Symptomatic vocal cord paralysis is an extremely rare complication of oesophageal dilatation or stent insertion, with only two previously reported cases described in the literature. In both cases, paralysis was suggested to be caused by recurrent laryngeal nerve compression from stent or dilatation.We present the case of a 63 year old female who developed immediate postoperative aphonia following a proximal oesophageal dilatation procedure for strictures. Flexible nasendoscopy of the larynx identified complete left sided vocal cord paresis causing her symptoms, which was presumed to be a complication of the dilatation.Keywords: Vocal cord; Paralysis; Esophageal; Dilatation; Iatrogenic

Pseudo-Ortner Syndrome

“…We were able to only find 3 published case reports in which esophageal dilation led to vocal cord paralysis from recurrent laryngeal nerve palsy. One case was due to iatrogenic dilatation of an esophageal stricture (7). The second and third case were due to dilation of the cervical esophagus secondary to achalasia (6) and stricture (9).…”

Bilateral vocal cord paresis as a rare complication of endoscopic retrograde cholangiopancreatography: a case report for the attention of endoscopist

“…The recurrent laryngeal nerve directly supplies posterior cricoarytenoid muscle which helps in cord abduction. 3 Most of laryngeal nerve paralysis is due to surgical procedures, anaesthesia complications or neurologic disorders. Patients with vocal cord paralysis usually present with changes in voice, aspiration and respiratory problems.…”

“…One of the few major causes of vocal cord paralysis are surgery, malignancy, idiopathic and trauma. [2][3][4] There was no case reported prior to this regarding vocal cord paralysis secondary to ERCP.…”

“…1 Patients with vocal cord paralysis usually present with symptoms such as hoarseness, dysphonia, dyspnea and aspiration and can reduce a person's quality of life. 2,3 Vocal cord paralysis can be caused by lesions or absence function at the nucleus ambiguus, supranuclear tracts, main trunk of the vagus nerve or its distal branch, the recurrent laryngeal nerve (RLN). 3,4 The most common causes include malignant tumours, iatrogenic injury during surgery involving the neck, thyroid gland, or chest, and various neurologic diseases.…”

“…2,3 Vocal cord paralysis can be caused by lesions or absence function at the nucleus ambiguus, supranuclear tracts, main trunk of the vagus nerve or its distal branch, the recurrent laryngeal nerve (RLN). 3,4 The most common causes include malignant tumours, iatrogenic injury during surgery involving the neck, thyroid gland, or chest, and various neurologic diseases. 2,4 Mechanical fixation can also cause failure of the movement of the vocal cords.…”