Single institutional analysis of trends over 45 years in etiology of vocal fold paralysis

Takano, Shingo; Nito, Takaharu; Tamaruya, Noriko; Kimura, Miwako; Tayama, Niro

doi:10.1016/j.anl.2012.02.001

Cited by 53 publications

(50 citation statements)

References 12 publications

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“…[1] Neurogenic immobility may result from damage to the vagus and recurrent nerve through surgeries or neoplastic invasion from brainstem to jugular foramen, neck, mediastinum, and aortic arch. [2]…”

Section: Introductionmentioning

confidence: 99%

Acquired unilateral vocal fold paralysis: Retrospective analysis of a single institutional experience

et al. 2013

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Background:Vocal cord paralysis continues to be an important issue in laryngology and is considered as a sign of underlying disease; the etiologies of this problem are varied and changing.Aims:The study was to carry out a retrospective analysis of patients with unilateral vocal fold paralysis diagnosed.Materials and Methods:The medical records of 53 patients diagnosed and treated for unilateral vocal fold paralysis were studied retrospectively. Data regarding age, sex, duration of symptoms, etiology, and side of paralysis were recorded.Results:Out of the 53 cases, 36 were females and 17 males with a ratio of 2.1:1. The age of the patients ranged from 17-75 years. In 18.9% the cause was idiopathic. Surgical trauma (iatrogenic) problems was the most encountered etiology (66%), others included malignancy (non laryngeal) (7.5%), central (3.8%), external neck trauma (1.9%) and radiation therapy 1.9%. Thyroid surgery was the most commonly reported neck surgery in 50.9%.Conclusions:Thyroidectomy continues to be the single most common surgical procedure responsible for unilateral vocal cord paralysis. For this reason, routine pre and postoperative laryngoscopy should be considered in all patients undergoing surgeries with a potential risk for recurrent nerve paralysis to reduce the postoperative morbidity.

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Section: Introductionmentioning

confidence: 99%

Acquired unilateral vocal fold paralysis: Retrospective analysis of a single institutional experience

et al. 2013

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“…[3] Another recent study conducted in Tokyo by Takano et al, a retrospective review of etiology over 45 years, showed that the surgery was the major cause of unilateral vocal cord palsy with thyroidectomy leading the group. [4] There have been very few studies on unilateral vocal cord palsy from the Indian subcontinent over the past three decades. Our study attempts to evaluate the etiological profile of unilateral vocal cord palsy over the past 10 years in our institute that is a tertiary referral center.…”

Section: Original Articlementioning

confidence: 99%

Etiological profile of unilateral vocal cord paralysis: A single institutional experience over 10 years

2014

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Objective: Unilateral vocal cord palsy is a major cause of dysphonia. With umpteen number of causes being attributed to it and changing trends in etiology from place-to-place and over time, it is of utmost importance to arrive at a correct diagnosis to plan further management and to determine the prognosis. The aim was to evaluate the etiological profile of unilateral vocal cord palsy in our institute that is a tertiary referral center over the past 10 years. Materials and Methods: Case records of all patients diagnosed with unilateral vocal cord palsy who presented to Deenanath Mangeshkar Hospital, Pune, Maharashtra, India between 2003 and 2013 were retrospectively reviewed. The exclusion criteria included patients with laryngeal/hypopharyngeal malignancies, intubation trauma, congenital vocal cord palsy and cricoarytenoid joint ankylosis. The age, gender, laterality and etiology were the factors taken into consideration. Results: A total of 277 cases spanning over the age range of 2 months to 98 years met our inclusion criteria, out of which 179 were males, and 98 were females with a male to female ratio being 1.82:1. In terms of laterality, 182 patients had left sided, and 95 had right sided vocal cord palsy. Majority of the cases were found to be in the fourth and fifth decades. The most common etiology was idiopathic 136 (49.1%). The incidence of various other etiologies were surgical trauma 60 (21.6%), nonsurgical trauma 10 (3.7%), nonlaryngeal malignancy 36 (12.9%), central/ neurological 17 (6.1%), postradiation 1 (0.3%), and other benign lesions 17 (6.1%). Among the surgical causes, the incidence of nonthyroidectomy surgeries (58.3%) was more than that of thyroidectomy (41.6%). Thyroidectomy was the single most common surgical cause for unilateral vocal cord palsy, followed by other nonthyroid neck surgeries (20%) and anterior cervical decompression (18.3%). Conclusion: The most common cause for unilateral vocal cord palsy is idiopathic. Nevertheless it is still an important sign of various underlying diseases. A thorough evaluation which must necessarily include a computerized tomographic scan from base of the skull to upper mediastinum is essential before labeling a case as idiopathic; hence, also the need for extended follow-up of the cases to avoid misdiagnosis of any underlying subclinical malignancy.

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“…However, it can be diagnosed by follow-up after surgery even in unsuspected cases. Although it is generally asymptomatic, patients with postoperative hematoma can suffer from a range of symptoms from ecchymosis to life-threating dyspnea (1,2).…”

Section: Introductionmentioning

confidence: 99%

“…Vocal cord paralysis (VCP) following thyroidectomy is another major complication, and its incidence has been varied (1,2). Although VCP following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology.…”

Section: Introductionmentioning

confidence: 99%

“…Vocal cord paralysis can result from nerve damage, such as transection (complete or partial), excessive traction, direct handling, contusion, crush, thermal injury, clamping, incorrect ligature, and compromised blood supply. In addition, neurological diseases, tuberculosis, aortic aneurysms, lung and mediastinal malignancies, esophageal malignancies, metastatic tumors, and post-anesthesia complications can cause VCP (1,2). According to a review by Jeannon et al (3) that includes 27 articles and evaluates over 25,000 patients, the average rate of temporary VCP is 9.8% (1.4%-38.4%), whereas the average rate of permanent VCP is 2.3% (0%-18.6%).…”

Section: Introductionmentioning

confidence: 99%

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A rare case of non-surgical vocal cord paralysis: Vocal cord hematoma

et al. 2017

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A rare case of non-surgical vocal cord paralysis: Vocal cord hematoma Although vocal cord paralysis (VCP) following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology. Vocal cord paralysis following thyroidectomy can be caused by a vocal cord hematoma with an incidence of 1.4% due to direct injury during orotracheal intubation. In this article, we present a case of VCP caused by vocal cord hematoma. A 32-year-old male patient who has been receiving propylthiouracil treatment for toxic multinodular goiter since 10 years was admitted to our hospital to be operated because of persisting complaints. The patient was hospitalized for sutureless thyroidectomy after he became euthyroid. Preoperative fiberoptic laryngoscopy performed by the ear, nose, and throat department revealed bilaterally motile vocal folds and a completely open airway. Patient underwent sutureless total thyroidectomy with a vessel sealing device (Ligasure TM LF1212, Covidien, CO), and a minivac drainage system was placed in the thyroid lodge. On the morning of the first postoperative day, 50 mL of serosanguinous fluid was drained. The patient's voice was normal, and there was no ecchymosis. Postoperative fiberoptic laryngoscopy revealed a hematoma near the right vocal fold and paralysis of the right vocal fold; however, the airway was open. It should be kept in mind that VCP is not solely due to surgery but can also result from intubation, as observed in this case. Keywords: Vocal cord hematoma, vocal cord paralysis, hematoma, thyroidectomy INTRODUCTIONThyroid surgery is one of the most popular surgeries worldwide. Postoperative hematoma after total thyroidectomy is a major but unpredictable complication. However, it can be diagnosed by follow-up after surgery even in unsuspected cases. Although it is generally asymptomatic, patients with postoperative hematoma can suffer from a range of symptoms from ecchymosis to life-threating dyspnea (1, 2).Vocal cord paralysis (VCP) following thyroidectomy is another major complication, and its incidence has been varied (1, 2). Although VCP following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology. Vocal cord paralysis can result from nerve damage, such as transection (complete or partial), excessive traction, direct handling, contusion, crush, thermal injury, clamping, incorrect ligature, and compromised blood supply. In addition, neurological diseases, tuberculosis, aortic aneurysms, lung and mediastinal malignancies, esophageal malignancies, metastatic tumors, and post-anesthesia complications can cause VCP (1, 2). According to a review by Jeannon et al. (3) that includes 27 articles and evaluates over 25,000 patients, the average rate of temporary VCP is 9.8% (1.4%-38.4%), whereas the average rate of permanent VCP is 2.3% (0%-18.6%). Vocal cord paralysis following thyroidectomy can result from a vocal cord hematoma with an incidence of 1.4%, due to direct injury during orotracheal intubation (incidence: 4.5%)(4, 5). In this articl...

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Single institutional analysis of trends over 45 years in etiology of vocal fold paralysis

Cited by 53 publications

References 12 publications

Acquired unilateral vocal fold paralysis: Retrospective analysis of a single institutional experience

Acquired unilateral vocal fold paralysis: Retrospective analysis of a single institutional experience

Etiological profile of unilateral vocal cord paralysis: A single institutional experience over 10 years

A rare case of non-surgical vocal cord paralysis: Vocal cord hematoma

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