Recurrent Laryngeal Nerve Paralysis. Clinical Observations of 156 Cases.

Recurrent Laryngeal nerve paralysis was studied in 156 patients seen in our clinic from 1987 to 1992. There were 92 males and 64 females. The age distribution showed a peak at 60 years in men and at 40 years in women. The paralyzed left vocal cord was in 83 patients, the right in 42, and both cords in 29. The paralysis was paramedian in 53, median in 52 and intermediate in 20. The cause of the palsy was surgery in 76 patients (thyroidectomy in 41, intrathoracic surgery in 24, and intubation in 11), brain damege in 6, intrathoracic disease in 21, neck disease in 11, and idiopathic in 43.The incidence of recurrent laryngeal nerve paralysis in Japan was determined from a survey of 5832 cases reported by several different clinics. Recurrent laryngeal nerve paralysis ranged from 0.36% to 1.04%, mean value in 0.63% of all new outpatients. Post operative recurrent laryngeal nerve paralysis accounted for 41.1%: thyroidectomy 14.7±5.7%, intrathoracic operation 10.3±3.2%, and post-intubation palsy 6.7±2.4%. The non-surgical causes were idiopathic 33.2±11.8%, and malignant tumors of the neck or chest 16.2±9.4%.