Clinico etiological spectrum of unilateral vocal cord paralysis - A prospective study

Abstract

Unilateral vocal cord palsy is relatively common in Otorhinolaryngology clinics. Due to reasons more than one, the exact incidence of the etiology behind unilateral vocal cord palsy has remained a mystery difficult to unfold. The present study was undertaken to determine the clinical presentation and etiopathology of unilateral vocal cord paralysis. The present study was a prospective study undertaken in the Department of Otorhinolaryngology at KIMS Hospital, Secunderabad from June 2018 to May 2020 after the approval of the Ethical Committee among 50 adult patients with a confirmed diagnosis of Unilateral Vocal cord palsy. Patients with the fixity of the vocal cord, laryngeal malignancies, and bilateral Vocal cord palsy/paresis were excluded from the study. A thorough history and ENT, head & neck examination followed by a radiological examination to make an etiological diagnosis of Vocal cord palsy were done. For patients with no cause found, a CT/ MRI imaging was done before labeling them as idiopathic. Most of the patients presented in the 4th and 5th decades of life, with male predominance. The most common presenting symptom was hoarseness of voice (80%) and Left-side vocal cord palsy (56%) is more common. The most common cause was idiopathic (34%) followed by post-surgical trauma, neoplastic, central cause, cardiac, granulomatous disorders, and neurological and post-intubation trauma respectively. In conclusion, our study shows thorough evaluation and investigation of cases with unilateral vocal cord palsy unveils interesting and sometimes rare and probably life-threatening underlying pathologies, that could be managed appropriately.