[Aetiology and treatment of vocal fold paralysis: retrospective study of 108 patients]

Abstract

Objectives: To review the aetiology and treatment of laryngeal paralysis diagnosed at our hospital and to describe the available therapeutic options.

Methods: Retrospective review of medical records of 108 patients diagnosed with unilateral and bilateral vocal fold paralysis between 2000 and 2012, identifying the cause of paralysis and its treatment.

Results: Of the 108 cases analysed, 70% had unilateral vocal fold immobility and 30% bilateral immobility. The most frequent aetiology in both cases was trauma (represented mainly by surgical injury), followed by tumours in unilateral paralysis and medical causes in bilateral paralysis. Half of the patients with unilateral paralysis (38) were treated surgically, with medialization thyroplasty. In bilateral vocal fold immobility, the treatment consisted of tracheostomy in patients with threatened airway (40%). We planned to widen the air passage in 9 patients (27%), performing cordectomy in most of them.

Conclusions: The aetiology observed in our patients is similar to that described in the literature. In cases of unilateral vocal fold paralysis, we believe thyroplasty is the procedure of choice. In bilateral paralysis, it is possible to perform cordectomy in selected patients once the airway has been secured.

Keywords: Cordectomy; Cordotomía; Inyección intracordal; Parálisis cuerda vocal; Thyroplasty; Tiroplastia; Vocal fold injection; Vocal fold paralysis.