ETIOPATHOGENESIS OF VOCAL CORD PARESIS AND PALSY IN A TERTIARY CARE CENTRE- A PROSPECTIVE STUDY

Abstract

The purpose of this study was to identify the patients with vocal cord paresis and palsy and to establish the etiology based on the study performed in a tertiary care centre. The study was done prospectively in the Department of ENT in Mahatma Gandhi Medical College & Hospital, Jaipur, for 1 year, from September 2020 to August 2021. 50 patients with vocal cord paresis and palsy were identied and examined by using exible or rigid laryngoscopy to make the etiological diagnosis. The etiology of vocal cord immobility was determined by history and complete head and neck examination. Patients in whom no cause was found, a CT scan from base of skull upto thorax was done before labelling them as idiopathic. Most patients presented with complaints of change in voice (92%). Other common presenting complaints included difculty in breathing, difculty in swallowing, vocal fatigue and cough. Unilateral vocal cord paralysis (88%) was more common than bilateral paralysis (12%), of which left (58%) was more commonly affected than right (42%) vocal cord because of longer intrathoracic course of left recurrent laryngeal nerve. The most common age group affected was 51–60 years (26%) followed by 61–70 years (18%). Males (60%) were affected more than females (40%) in a ratio of 3:2 and among the affected males 80% were known smokers. The most common cause of vocal cord paresis and palsy was found to be malignancy larynx (36%), followed by idiopathic (28%). Other causes included carcinoma of lung, thyroid and oesophagus, inammatory, traumatic, systemic diseases like Rheumatoid Arthritis and Hypertension leading to stroke. Identifying the exact etiopathogenesis of vocal cord paresis and palsy in patients has been a challenge and is very important in order to establish a proper diagnostic and treatment protocol for these patients.