Characteristics of 32 Associated Laryngeal Paralysis Cases

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  • Yamauchi Akihito
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan Department of Otolaryngology, The University of Tokyo Hospital
  • Ohki Masafumi
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan Department of Otolaryngology, The University of Tokyo Hospital
  • Kato Hiromu
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan
  • Kishida Sakurako
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan
  • Kitano Mutsukazu
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan
  • Kumagai Yuzuru
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan
  • Nakai Atsuhito
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan
  • Hukuoka Hisayo
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan
  • Tayama Niro
    Department of Otolaryngology and Tracheo-esophagology, International Medical Center of Japan Department of Otolaryngology, The University of Tokyo Hospital

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Other Title
  • 当科における混合性喉頭麻痺３２例の臨床的検討
  • 当科[竹田綜合病院耳鼻咽喉科]における混合性喉頭麻痺32例の臨床的検討
  • トウ カ タケダ ソウゴウ ビョウイン ジビ インコウカ ニ オケル コンゴウセイ コウトウ マヒ 32レイ ノ リンショウテキ ケントウ

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Abstract

To reveal the characteristics of associated laryngeal paralysis, we performed a clinical study through a chart review of patients visiting our department between June 2003 and December 2007. A total of 32 patients (23 men, 9 women ; age range, 21-86) with associated laryngeal paralysis were assessed for causes, severity, prognosis and treatments.<br>The most frequent chief complaints were dysphagia (25 cases) and hoarseness (17 cases). Causes included cerebrovascular disease (8 cases), head and neck tumor (6 cases), operation for head and neck tumor (5 cases) and varicella-zoster virus (8 cases). Vocal cord paralysis was complete in 24 cases, and incomplete in 8 cases. The affected side was right in 13 cases, left in 16 cases, and bilateral in 3 cases. Aside from vocal cord palsy, the vagus nerve (32 cases), glossopharyngeal nerve (32 cases), hypoglossal nerve (10 cases), facial nerve (7 cases) and accessory nerve (5 cases) were frequently involved. Patients were observed for 9.5 months on average, and 15 cases revealed improved vocal cord function (fully recovered in 3 cases ; partially recovered in 12 cases). Viral cases showed a better prognosis than any other cases, whereas those with cerebrovascular disease, tumor, and head and neck operation showed a poor prognosis, and 10 cases among them (18 cases) underwent an operation to improve swallowing function.<br>The profile of associated laryngeal paralysis is different from that of vocal cord paralysis alone. Viral involvement is a good prognostic indicator, whereas the involvement of cerebrovascular disease, tumor, and head and neck operation means a poor prognosis, and surgical intervention should be considered.

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