声帯麻痺症例の原因と予後の検討

抄録

Introduction/Purpose: Vocal cord paralysis causes hoarseness of the voice and greatly reduces the QOL. Therefore, it is essential for otorhinolaryngologists to fully understand the causes and prognosis of vocal cord paralysis. In this study, we investigated the proportion of cases of vocal cord paralysis by cause and prognosis.

Subjects/Methods: The study was conducted in a total of 183 patients who were diagnosed as having vocal cord paralysis by laryngeal endscopy at our hospital between April 1, 2004, and March 31, 2021. The patients were classified by the cause of the vocal cord paralysis, age, sex, and the paralyzed side. In addition, in 167 patients with vocal cord paralysis who could be followed up, we investigated the period from the onset of vocal cord paralysis to recovery.

Results: Of the 183 patients, the cause of the paralysis was idiopathic in 62 cases, neoplastic in 42 cases, postoperative in 40 cases, post-intubation in 21 cases, infection in 7 cases, arterial in 6 cases, trauma in 2 cases, and central in 1 case. Of the 167 patients who could be followed up, 46 (27.5%) recovered completely, with complete resolution of the vocal cord paralysis and subjective symptoms. 80 cases (47.9%) improved subjective symptoms (including 46 cured cases). There were 87 cases (52.1%) in whom neither the vocal cord paralysis nor the subjective symptoms improved.

Conclusion: In all the 46 cases with complete resolution of the paralysis and subjective symptoms, the time from onset of symptoms to recovery was less than 1 year. Therefore, we consider that patients with vocal cord paralysis should be followed up for at least 1 year after onset of the paralysis.