[Cause, diagnosis and course in 215 patients with vocal cord paralysis].

OBJECTIVE: To assess the different causes, the diagnostic process and natural course of vocal cord paralysis. DESIGN: A retrospective study. SETTING: Department of ENT, University Hospital Nijmegen, the Netherlands. METHOD: Between 1982 and 1990, 215 patients with the symptoms of vocal cord paralysis were routinely examined. In 40 patients additional examination was needed to determine the diagnosis. RESULTS: A substantial part of all cases (43%) were caused by previous medical intervention, for instance thyroid or thoracic surgery. Neoplasms of the head and neck region or thoracic cavity were a cause in 25%. In spite of extensive examination the cause of a vocal cord paralysis remained unclear in 18%. Physical examination combined with chest X-ray were the main diagnostic methods. Spontaneous recovery of a vocal cord paralysis was seen in 18% of all patients, but in the subgroup with paralysis after prolonged intubation or a viral infection it occurred in 46% and 62%, respectively. CONCLUSION: A vocal cord paralysis can have many causes. Physical examination and chest X-ray are important tools for diagnosis.