Unilateral Vocal Cord Palsy: An Etiopathological Study

Unilateral vocal cord palsy (UVCP) is not an uncommon finding in ENT practice. It is not a diagnosis by itself. The exact incidence of UVCP has been difficult to find out because of multiple reasons. Many cases are underdiagnosed because of spontaneous recovery or compensation by the opposite cord. Also, a good number of patients with postoperative hoarseness do not undergo a laryngoscopic evaluation.1 It has been found that etiology of UVCP shows a changing trend varying with time and place of study. In 1930’s aortic aneurysm (syphilitic) and thyroidectomy were the most common causes of UVCP. Many of those conditions, like syphilitic aneurysm and tuberculous mediastinal nodes became rare or disappeared.2 The relative incidence of nonlaryngeal malignancy increased and it became the most frequent cause of UVCP in 90’s. With technological advances in anesthesia and surgery, the relative number of other surgical procedures like anterior cervical spine surgery, carotid endarterectomy, skull base procedures, etc. with the potential for recurrent nerve paralysis went up and thus brought down the relative incidence of thyroidectomy induced UVCP. However, the incidence of UVCP of unknown cause (idiopathic) has not reduced despite advances in imaging.2 Medline search of papers on etiology of UVCP found a large number of studies from different parts of the world but hardly any from Indian subcontinent in the last 30 years. This study intends to look into the current etiological trends in our center and compare them with previous studies.