We report a case of herpes zoster of the larynx in a 75-year-old man who presented with sore throat, dysphagia and singultus. At presentation, flexible fiberoptic laryngoscopy revealed white coating and swelling and erythema localized to the left epiglottic and supraglottic regions, but there was no evidence of soft palate paralysis or vocal cord paralysis at the first visit. With a strong suspicion of varicella-zoster virus (VZV) infection, the patient was treated with acyclovir. Nine days after admission, however, we found left soft palate paralysis and left vocal cord paralysis. The patient was initiated on treatment with corticosteroids, which led to complete recovery within 5 days. It was suspected that inflammation caused by VZV re-activation affected the vagus and glossopharyngeal nerves. In cases with acute onset of unilateral vocal cord paralysis, steroids and antiviral therapy should be considered.
