Respiratory and phonatory impairment due to iatrogenic vocal fold paralysis and paresis. A retrospective study of 188 patients

A. G. Anghel, I. Anghel, M. Dumitru, C. C. Soreanu,

Abstract: Purpose: We conducted a retrospective descriptive study comprising the patients diagnosed with vocal cords paralysis in the ENT Clinic from Coltea Clinical Hospital Bucharest in order to inventory the iatrogenic cases. Scientific background: The leading causes are trauma for vocal fold paralysis and paresis both surgical and nonsurgical, neoplasm and central nervous system diseases. Even with the multitude of current modern diagnostic investigations a large number of cases remain idiopathic. Adults suffer unilateral paresis more often than bilateral disease and left-sided lesions account for around two thirds of unilateral cases. The leading operation responsible for iatrogenic injury to both vocal folds is the total thyroidectomy. Intubation injuries commonly cause bilateral disease. Patients and methods: The descriptive analysis of our study group focused on gender distribution, age groups distribution, types of lesions according to ICD10 criteria and identifying current etiologies such as: surgery, neoplasm, idiopathic, CNS lesions, intubation, etc. Results and discussions: According to our data the study group presents numerous specific characteristics: male predominance, almost equal distribution between rural and urban living environment, maximum number of cases in between the ages of 55 and 74 years, etc. We have identified 23,40% iatrogenic lesions. Unfortunately almost all the bilateral lesions were associated with thyroid surgery. Conclusions: There are a great number of bilateral and unilateral iatrogenic lesions associated with surgical procedures because Romania is endemic for thyroid pathology
Keywords: vocal fold paralysis and paresis, iatrogenic injury, total thyroidectomy, laryngeal nerve lesions, phonosurgery.