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Laryngoscope. 1998 Sep;108(9):1346-50.

Changing etiology of vocal fold immobility.

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Department of Otolaryngology, Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202-2689, USA.



Vocal fold immobility is a sign of underlying disease. When the etiology remains unclear, evaluation may become time consuming and costly, and directed work-up imperative. This study examined the hypothesis that the etiologies of vocal fold immobility are changing, with extralaryngeal malignancies and nonthyroidectomy surgical trauma having become more common causes.


A retrospective review of consecutive patients with vocal fold immobility who had an adequate workup to determine the etiology.


Three hundred ninety-seven cases with a determined etiology were identified, yielding 280 unilateral and 117 bilateral immobilities. The largest single category in unilateral immobility was nonlaryngeal malignancy--69 patients (24.7%)--80% of which were pulmonary or mediastinal, followed by 67 patients (23.9%) with immobility secondary to surgical trauma. Thyroidectomy accounted for only 8.2%. The leading cause of bilateral immobility was surgical trauma-30 patients (25.7%)--21 (18%) of whom had thyroidectomy. Acute and chronic intubation injuries accounted for 21 unilateral (7.5%) and 18 bilateral (15.4%) cases.


These data indicate a changing etiology of vocal fold immobility, with growing percentages of extralaryngeal malignancies and surgery-related injuries. These findings have implications for the timing and method of management based on anticipated outcome.

[Indexed for MEDLINE]

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