This 20-year longitudinal assessment revealed that the etiology of unilateral vocal fold immobility has changed such that there has been a shift from extralaryngeal malignancies to nonthyroid surgical procedures as the major cause. Thyroid surgery remains the most common cause of bilateral vocal fold immobility.
Although the development of head and neck cancer is a rare side effect of immunosuppression, it still warrants attention. These patients have been found to be less likely to survive >1 year when compared to their nontransplant counterparts. Patients who develop head and neck malignancies following organ transplantation require aggressive screening, treatment, and follow-up, as this diagnosis may portend a poor prognosis.
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