UNILATERAL VOCAL CORD PALSY: Study of the causes of palsy and the role of CECT neck and thorax in establishing diagnosis.

Dr. Ruta K. Sayani; Dr. Rajesh Vishwakarma; Dr. Bela Prajapati; Dr. Devang Gupta; Dr. Nikhil Patel

Volume : V, Issue : I, January - 2015

UNILATERAL VOCAL CORD PALSY: Study of the causes of palsy and the role of CECT neck and thorax in establishing diagnosis.

Dr. Ruta K. Sayani, Dr. Rajesh Vishwakarma, Dr. Bela Prajapati, Dr. Devang Gupta, Dr. Nikhil Patel

Abstract :

AIM: To study the common causes of unilateral vocal cord palsy and to analyze the role of CECT neck and thorax in evaluation of patients with unilateral vocal cord palsy. MATERIAL AND METHODS: It is a retrospective study of 25 patients who were diagnosed with unilateral vocal cord palsy in Civil Hospital, Ahmedabad, ENT Department from the period of November 2013 to November 2014. Patients in whom iatrogenic or traumatic causes were implicated were excluded from the study. OBSERVATION AND DISCUSSION: It was observed from our study that left vocal cord was more commonly involved. Idiopathic cause was the most common cause of palsy followed by onchogenic carcinoma. In 6 out of the 8 cases with mass in the aortico–pulmonary window, the causative pathology was missed by x–ray chest (PA view). The common signs of vocal cord palsy on CT thorax were dilation of the ipsilateral pyriform sinus, thickening and medial position of the ipsilateral aryepiglottic fold, and dilated ipsilateral laryngeal ventricle. CONCLUSION: CECT neck and thorax should be performed in all the cases of unilateral vocal cord paralysis with no apparent pathology on physical examination and chest x–ray. A case of palsy can be labelled as idiopathic only after thorough history taking, physical examination, Chest X–ray, CECT neck and thorax and after ruling out central causes. A thorough search for underlying cause of palsy should be made because it can be a sign of underlying malignancy in many cases.