Clinical Evaluation of Patients with Vocal Cord Palsy

—Rate and Timing of Phonation Recovery by Disease Differences—

Abstract

Vocal cord palsy (VCP) is common in otolaryngological clinics, as are postoperative patients with VCP at general and university hospitals. Although VCP treatment strategies have been discussed, decisions on treatment methods and timing are complicated by the spontaneous recovery exhibited by some patients. We studied clinical features of VCP patients and their histories. Subjects were 171 VCP patients seen at our phonation clinic during a 15-year period-18% of all phonation clinic cases. By gender, 69% were male and 31% were female, ranging in age from 4 to 89 (mean, 58) years. Some 18% were bilateral and 82% unilateral, with 71% of unilateral cases on the left. Postoperative VCP occurred in 59% of patients in common surgical procedures for esophageal and thyroid tumors. During follow-up, 58% spontaneously recovered phonation. Postintubation VCP had the best recovery at 82%. Half with phonation recovery had spontaneous recovery from VCP and the other half had compensation. Most VCP resolved within 1 year, but compensation occurred after 1 year, meaning that in treatment planning and explanation, to VCP should be considered curable within 1 year and compensation attained 1 year after VCP.