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Laryngoscope. 2007 Oct;117(10):1864-70.

Vocal fold immobility: a longitudinal analysis of etiology over 20 years.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Medical Group, Detroit, Michigan, USA. lrosenthal@alumni.upenn.edu

Abstract

OBJECTIVES:

To determine the current etiology of vocal fold immobility, identify changing trends over the last 20 years, and compare results to historical reports.

STUDY DESIGN:

The present study is a retrospective analysis of all patients seen within a tertiary care institution between 1996 and 2005 with vocal fold immobility. The results were combined with a previous study of patients within the same institution from 1985 through 1995. Results were compared to the literature.

METHODS:

The medical records of all patients assigned a primary or additional diagnostic code for vocal cord paralysis were obtained from the electronic database.

RESULTS:

Eight hundred twenty-seven patients were available for analysis (435 from the most recent cohort), which is substantially larger than any reported series to date. Vocal fold immobility was most commonly associated with a surgical procedure (37%). Nonthyroid surgeries (66%), such as anterior cervical approaches to the spine and carotid endarterectomies, have surpassed thyroid surgery (33%) as the most common iatrogenic causes. These data represent a change from historical figures in which extralaryngeal malignancies were considered the major cause of unilateral immobility. Thyroidectomy continues to cause the majority (80%) of iatrogenic bilateral vocal fold immobility and 30% of all bilateral immobility.

CONCLUSIONS:

This 20-year longitudinal assessment revealed that the etiology of unilateral vocal fold immobility has changed such that there has been a shift from extralaryngeal malignancies to nonthyroid surgical procedures as the major cause. Thyroid surgery remains the most common cause of bilateral vocal fold immobility.

PMID:
17713451
DOI:
10.1097/MLG.0b013e3180de4d49
[Indexed for MEDLINE]

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