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- Title
Vocal Fold Immobility: A Longitudinal Analysis of Etiology Over 20 Years.
- Authors
Rosenthal, Laura H. Swibel; Benninger, Michael S.; Deeb, Robert H.
- 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.
- Publication
Laryngoscope, 2007, Vol 117, Issue 10, p1864
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1097/MLG.0b013e3180de4d49