Abstract
One hundred and sixty-four cases (109 males and 55 females) with recurrent laryngeal nerve paralysis examined at Himeji Medical Center between April 2001 and March 2005 were reviewed. Patient ages ranged from 19 to 89 years with an average of 65.5 years. The left vocal cord was affected in 109 cases (66.5%), the right one in 42 cases (25.6%) and the bilateral cords in 13 cases (7.9%). The causes of paralysis could be identified by examination in 41 (61.2%) of 67 cause-unknown cases and could not be identified in 26 (15.9%) of all 164 cases. Eighty-seven cases (53.0%) were related to malignant diseases. The most frequent cause was lung cancer in 57 cases (45 males and 12 females). The number of left, right and bilateral paralysis cases were 44 (77.2%), 12 (21.1%) and one (1.8%), respectively. Lung cancer was predominant among men with left-side paralysis. Among 57 lung cancer cases, lesions involving the recurrent laryngeal nerve were the primary pulmonary tumor in 17 cases (29.3%), subaortic lymph node in 11 cases (19.0%), mediasinal lymph node without subaortic lymph node in 27 cases (46.6%), and brain metastatic lesion in 3 cases (5.2%). It is important for the etiology of vocal cord paralysis to examine mediastinal lymph nodes as lung cancer metastasis. Twelve cases of esophageal cancer consisted of 4 cases (33.3%) with right paralysis, 5 cases (41.7%) with left paralysis and 3 cases (25.0%) with bilateral paralyses. The primary esophageal tumor was the lesion involving the recurrent laryngeal nerve in 3 left cases and 3 bilateral cases. Lymph node along the recurrent laryngeal nerve involved the nerve in 4 right cases and 2 left cases.
