Vocal cord paralysis and its etiologies: a prospective study

Seyed Javad Seyed Toutounchi, Mahmood Eydi, Samad Ej Golzari, Mohammad Reza Ghaffari, Nashmil Parvizian, Seyed Javad Seyed Toutounchi, Mahmood Eydi, Samad Ej Golzari, Mohammad Reza Ghaffari, Nashmil Parvizian

Abstract

Introduction: Vocal cord paralysis is a common symptom of numerous diseases and it may be due to neurogenic or mechanical fixation of the cords. Paralysis of the vocal cords is just a symptom of underlying disease in some cases; so, clinical diagnosis of the underlying cause leading to paralysis of the vocal cords is important. This study evaluates the causes of vocal cord paralysis.

Methods: In a prospective study, 45 patients with paralyzed vocal cord diagnosis were examined by tests such as examination of the pharynx, larynx, esophagus, thyroid, cervical, lung, and mediastinum, brain and heart by diagnostic imaging to investigate the cause vocal cord paralysis. The study was ended by diagnosing the reason of vocal cord paralysis at each stage of the examination and the clinical studies.

Results: The mean duration of symptoms was 18.95±6.50 months. The reason for referral was phonation changes (97.8%) and aspiration (37.8%) in the subjects. There was bilateral paralysis in 6.82%, left paralysis in 56.82% and right in 63.36% of subjects. The type of vocal cord placement was midline in 52.8%, paramedian in 44.4% and lateral in 2.8% of the subjects. The causes of vocal cords paralysis were idiopathic paralysis (31.11%), tumors (31.11%), surgery (28.89%), trauma, brain problems, systemic disease and other causes (2.2%).

Conclusion: An integrated diagnostic and treatment program is necessary for patients with vocal cord paralysis. Possibility of malignancy should be excluded before marking idiopathic reason to vocal cord paralysis.

Keywords: Etiology; Larynx; Paralysis; Vocal Cord.

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References

    1. Golzari SE, Khan ZH, Ghabili K, Hosseinzadeh H, Soleimanpour H, Azarfarin R, Mahmoodpoor A. et al. Contributions of medieval Islamic physicians to the history of tracheostomy. Anesth Analg. 2013;116:1123–32.
    1. Golzari SE, Khodadoust K, Alakbarli F, Ghabili K, Islambulchilar Z, Shoja MM. et al. Sleep paralysis in medieval Persia–the Hidayat of Akhawayni (?–983 AD) Neuropsychiatr Dis Treat. 2012;8:229–234.
    1. Khalili M, Aslanabadi A, Golzari SE, Ghabili K. Arsenicals for dental and gingival diseases in medieval Persia. J Formos Med Assoc. 2013;112:59–60.
    1. Golzari SE, Ghabili K, Sajadi MM, Aslanabadi S. Early descriptions of Grisel’s syndrome. Childs Nerv Syst. 2013;29:539–360.
    1. Golzari SE, Ghabili K. Alcohol-mediated sleep paralysis: the earliest known description. Sleep Med. 2013;14:297–300.
    1. Montazeri V, Sokouti M, Golzari S. The incidence of transient and transient hypocalcemia after total thyroidectomy in thyroid cancers. Int J Endocrinol Metab. 2010;2:271–276.
    1. Agamohamdi D, Hosseinzadeh H, Golzari S, Alizadeh A, Peirovyfar A, Movassaghi R. et al. Preincisional ipsilateral stellate ganglion block for acute post-operative pain control in unilateral mastectomy. Pak J Med Sci. 2011;27(4):879–883.
    1. Eydi M, Kolahdouzan K, Golzari SE. Effect of Intravenous Hydrocortisone on Preventing Postoperative Sore Throat Followed by Laryngeal Mask Airway Use in patients Undergoing Urogenital Surgeries. J Cardiovasc Thorac Res. 2013;5:29–33.
    1. Peirovifar A, Eydi M, Mirinejhad MM, Mahmoodpoor A, Mohammadi A, Golzari SE. Comparison of postoperative complication between Laryngeal Mask Airway and endotracheal tube during low-flow anesthesia with controlled ventilation. Pak J Med Sci. 2013;29:601–605.
    1. Hosseinzadeh H, Talesh KT, Golzari SE, Gholizadeh H, Lotfi A, Hosseinzadeh P. Warming Endotracheal Tube in Blind Nasotracheal Intubation throughout Maxillofacial Surgeries. J Cardiovasc Thorac Res. 2013;5:147–151.
    1. Farhoudi M, Ayromlou H, Bazzazi AM, Shadi FB, Golzari SE, Ghabili K. et al. Time Frequency of Guillain-Barre Syndrome in Northwest of Iran. Life Sci J. 2013;10:223–225.
    1. Ayromlou H, Khanli HM, Yazdchi-Marandi M, Rikhtegar R, Zarrintan S, Golzari SE. et al. Electrodiagnostic Evaluation of Peripheral Nervous System Changes in Patients with Multiple Sclerosis. Malays J Med Sci. 2013;20:31–37.
    1. Mau T. Diagnostic evaluation and management of hoarseness. Med Clin North Am. 2010;94:945–60.
    1. Feierabed RH, Shahram MN. Hoarseness in Adults. Am Fam Physician. 2009;80:363–370.
    1. Agha FP. Recurrent Laryngeal nerve paralysis: a laryngographic and computed tomographic study. Radiology. 1983;148:149–155.
    1. Yumoto E, Sanuki T, Hyodo M. Three dimensional endoscopic images of vocal cord paralysis by computed tomography. Arch Otolaryngol Head Neck Surg. 1999;125:883–890.
    1. Yumoto E, Oyamada Y, Nakano K, Nakayama Y, Yamashita Y. Three-dimensional characteristics of the larynx with immobile vocal cord. Arch Otolaryngol Head Neck Surg. 2004;130:967–974.
    1. Benninger MS, Gillen JB, Altman JS. Changing etiology of vocal cord immobility. Laryngoscope. 1998;108:1346–50.
    1. Bando H, Nishio T, Bamba H, Uno T, Hisa Y. Vocal cord paralysis as a sign of chest diseases: a 15-year retrospective study. World J Surg. 2006;30:293–8.
    1. Furukawa M, Furukawa MK, Ooishi K. Statistical analysis of malignant tumors detected as the cause of vocal cord paralysis. ORL J Otorhinolaryngol. 1994;56:161–5.
    1. Titche LL. Causes of recurrent laryngeal nerve paralysis. Arch Otolaryngol. 1976;102:259–61.
    1. Evans JM, Schucany WG. Hoarseness and cough in a 67-year-old women. Proc (Bayl Univ Med Cent) 2004;17:469–72.
    1. Chen HC, Jen YM, Wang CH, Lee JC, Lin YS. Etiology of vocal cord paralysis. ORL J Otorhinolaryngol Relat Spec. 2007;69:167–71.
    1. Terris DJ, Arnstein DP, Nguyen HH. Contemporary evaluation of unilateral vocal cord paralysis. Otolaryngol Head Neck Surg. 1992;107:84–90.
    1. Glazer HS, Aronberg DJ, Lee JK, Sagel SS. Extralaryngeal causes of vocal cord paralysis: CT evaluation. AJR Am J Roentgenol. 1983;141:527–31.
    1. Tasar A, Yanturali S, Topacoglu H, Ersoy G, Unverir P, Sarikaya S. Clinical efficacy of dexamethasone for acute exudative pharyngitis. Clin J Emerg Med. 2008;35:363–67.
    1. Sagawa M, Donjo T, Isobe T, Notake S, Nakai M, Sugita M. et al. Bilateral vocal cord paralysis after lung cancer surgery with a double-lumen endotracheal tube: a life-threatening complication. J Cardiothorac Vasc Anesth. 2006;20:225–6.
    1. Flint PW, Purcell LL, Cummings CW. Phatophysiology and indications for medicalization thyroplasty in patients with dysphagia and aspiration. Otolaryngol Head Neck Surg. 1997;116:349–54.
    1. Harries ML. Unilateral vocal cord paralysis: a review of the current methods of surgical rehabilitation. J Larungol Otol. 1996;110:111–116.
    1. Yumoto E, Minoda R, Hyodo M, Yamagata T. Causes of recurrent laryngeal nerve paralysis. Auris Nasus Larynx. 2002;29:41–5.
    1. Rosenthal LH, Benninger MS, Deeb RH. Vocal cord immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope. 2007;117:1864–70.
    1. Ko HC, Lee LA, Li HY, Fang TJ. Etiologic Features in patients with Unilateral Vocal Cord Paralysis in Taiwan. Chang Gung Med J. 2009;32:290–6.
    1. Srirompotong S, Sae-Seow P, Srirompotong S. The cause and evaluation of unilateral vocal cord paralysis. J Med Assoc Thai. 2001;84(6):855–8.
    1. Ramadan HH, Wax MK, Avery S. Outcome and changing cause of unilateral vocal cord paralysis. Otolaryngol Head Neck Surg. 1998;118:199–202.

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