Vocal fold immobility: a longitudinal analysis of etiology over 20 years.
Laryngoscope
; 117(10): 1864-70, 2007 Oct.
Article
em En
| MEDLINE
| ID: mdl-17713451
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. STUDYDESIGN:
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.
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Base de dados:
MEDLINE
Assunto principal:
Paralisia das Pregas Vocais
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Laryngoscope
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Estados Unidos