Bilateral vocal fold paralysis: causes and treatment – 12 years’ experience
DOI:
https://doi.org/10.34631/sporl.2183Keywords:
bilateral vocal fold paralysis, rare causes stridor, hypocalcaemia, hypothyroidism, neurosyphilis, posterior cordotomy, tracheostomyAbstract
Aim: To analyse the cases of bilateral vocal fold paralysis (BVFP) diagnosed by the ENT department at Hospital Garcia de Orta. To emphasize rare causes of this entity and its treatment.
Study design: Retrospective study of BVFP cases diagnosed between January 2011 and December 2022.
Materials and methods: Inclusion criteria: diagnosis of BVFP by an ENT with videonasolaryngoscopy documentation. Patients with pharyngolaryngeal neoplasia and insufficient records were excluded.
Results: 109 patients were diagnosed with BVFP. The mean age at diagnosis time was 67 years. The presenting symptoms were: acute high dyspnoea in 92.7%, dysphonia in 19.3% and dysphagia in 7.3%. Rare causes were diagnosed: degenerative neurological diseases, neoplasms (thymus, oesophagus, lung, central nervous system), newly brain metastasis, hypocalcaemia, hypothyroidism, neurosyphilis, acute hepatitis B, meningitis and rheumatoid arthritis. 78% patients were approached surgically: tracheostomy, posterior cordotomy using LASER® and vocal cord lateralization.
Conclusions: The etiological investigation with imaging exams and analytical evaluation allowed the diagnosis of rare causes of BVFP. In some cases, correction of the underlying cause has allowed reversion of vocal fold paralysis.
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