Bilateral vocal fold paralysis: a retrospective study with novel and extremely rare causes of the condition

Nelson Gilberto, Clara Capucho, Pedro Sousa, Pedro Escada

Resumen

Background: Vocal fold paralysis is the immobilization of the vocal fold due to an impaired function of the vagus or recurrent laryngeal nerve.

The aim of this study is to describe the most relevant aspects of the bilateral vocal fold paralysis (BVFP) in a series of 18 patients.

Material and Methods: A retrospective study regarding the 2005 to 2016 period was conducted concerning symptoms, etiology and treatment. Obtained data were compared with medical literature.

Results: Eighteen cases were enrolled in this study. The mean age was 60 ± 16 years and the main symptoms at presentation were upper airway dyspnea in 15 (83%) cases, dysphonia in 11 (61%), stridor in 4 (22%) and dysphagia in 3 (17%).

Surgical trauma was responsible for 11 (61%) cases: 7 after thyroidectomy, 3 after cardiac surgery and 1 after mandibular surgery. The remaining 7 cases causes were: Parkinson’s disease, multiple system atrophy, neoplastic meningitis due to T-cell acute lymphoblastic leukemia, breast cancer with pulmonary metastasis, laryngeal sarcoidosis, brainstem abscess and one with idiopathic cause. Twelve patients (67%) were treated surgically. Six (33%) patients did not receive surgical treatment. During the follow-up, all the patients were successfully decannulated.

Conclusion: The overall clinical features and treatment of BVFP were in accordance with the medical literature. Some of the presented cases represented extremely rare causes such as neoplastic meningitis due to leukemia and laryngeal sarcoidosis. Surgical treatment resulted in the resolution of the dyspnea, but with vocal quality deterioration.

Palabras clave

Vocal Cord Paralysis; Glottis; Paralysis; Sarcoidosis; Meningeal Carcinomatosis

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Referencias

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