Antituberculosis drugs and thoracic surgery have reduced the incidence of recurrent laryngeal nerve paralysis due to pulmonary tuberculosis. The onset and course of this condition may also have changed, but no details have been reported yet. During the past 10 years, 12 patients with this paralysis have visited our clinic.
1) They represent only 0.4% of the total of 299 patients with recurrent laryngeal nerve paralysis seen during this period.
2) There were no patients bilateral paralysis and 11 of the 12 had paralysis on the left side.
3) The pulmonary lesion and laryngeal paralysis were on the same side except in one patient who had left laryngeal paralysis and right pulmonary tuberculosis.
4) There was an interval of 20-30 years between the onset of pulmonary tuberculosis (at 32.2 years of age on the average) and the development of recurrent laryngeal nerve paralysis (at 58.6 years of age old on the average). Since it occurs in an older age group it must be differentiated from lung cancer.
5) The common findings of CT-scan examination in 3 cases were shifting of the mediastinum to the left, diminished left thoracic space, and thickening of the pleura. These findings indicate that the cause of this paralysis is pressure and retraction of the nerve by scar tissue. We consider, moreover, that the vulnerability of the recurrent laryngeal nerve might have been increased by chronic local circulatory disturbance, because the nerve was usually surrounded by scar tissue.
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