Etiological Factors and Management of Vocal Fold Paralysis: Single Institution Study

Abstract

Vocal fold paralysis is a sign of underlying diseases. However, etiologies of this problem are varied and changing from center to center and need more clarification. The aim of the study is to determine the etiological factors and management options of vocal fold paralysis among patients attended to the voice clinic center at King Abdul-Aziz Medical City. The medical records of 106 patients diagnosed with vocal fold paralysis were studied retrospectively. The following variables were recorded; age, gender, occupation, smoking, surgical history, radiation history, cause and type of vocal fold paralysis, associated risks, and management. Out of the 106 cases, 58 were males and 48 females with a ratio of 1.2:1. The age of the patients ranged from 6-92 years. Surgical trauma (iatrogenic) was the leading cause of vocal fold paralysis (45.3%) followed by idiopathic (17.9%), external neck trauma (13.2), Non-laryngeal malignancy (6.6%), post upper respiratory tract infection and viral infection (5.7%), TB and TB lymphadenitis (3.8%), intubation (2.8%), neurogenic (1.8%) and thyroid mass (1.8%). Total thyroidectomy was the most common surgical etiology of vocal fold paralysis (38.8%). The most common etiology of vocal fold paralysis is surgery and most cases were total thyroidectomy. Otolaryngologists should be familiar with the etiology, incidence, evaluation, and management options of vocal fold paralysis to optimize patient care and avoid further complication. We recommend that all patients undergoing total thyroidectomy and surgeries related to the course of recurrent laryngeal nerves should have detailed voice assessment pre-and postoperatively.