Vocal Cord Paralysis Secondary to Carotid Artery Dissection: A Case Report

Abstract

Background and Objective: Vocal cord paralysis results in impairment of breathing and/or speech. One of the causes of vocal cord paralysis is the disruption of vagus nerve innervation to the vocal cords by the mass effect of a neighbouring structure. We report a rare case of vocal cord paralysis secondary to internal carotid artery dissection. Method: The diagnosis was based on clinical history, physical examination and imaging studies. Literature review was done. Case Report: This was a 53-year-old female with a history of unremitting, progressive hoarseness and mild dysphagia to liquid, who was clinically found to have impaired left vocal cord mobility, a left-sided pulsatile neck mass and left carotid artery dissection based on imaging studies. Symptoms abated after conservative treatment with Aspirin and she has remained symptom free since two years of follow-up. Conclusion: Vocal cord paralysis can be a consequence of carotid artery dissection causing mass effect on the vagus nerve. Thus, carotid artery dissection should not be forgotten as a possible cause of vocal cord paralysis in some cases of vocal cord paralysis of uncertain etiology. Treatment with anti-platelet drug can bring about resolution of symptoms and return of vocal cord mobility.