Neck ultrasonography for the evaluation of the etiology of adult unilateral vocal fold paralysis

Authors

  • Cheng-Ping Wang MD,

    1. Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
    2. Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
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  • Tseng-Cheng Chen MD,

    1. Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
    2. Department of Otolaryngology, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
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  • Pei-Jen Lou MD, PhD,

    1. Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
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  • Tsung-Lin Yang MD,

    1. Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
    2. Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
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  • Ya-Ling Hu RN, MSN,

    1. Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
    2. School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Ming-Jium Shieh MD, PhD,

    1. Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
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  • Jenq-Yuh Ko MD, PhD,

    1. Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
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  • Tzu-Yu Hsiao MD, PhD

    Corresponding author
    1. Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
    • Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
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Abstract

Background

An extralaryngeal neoplasm involving the vagus nerve and recurrent laryngeal nerve must be excluded when adult unilateral vocal fold paralysis is diagnosed.

Methods

Between 2004 and 2009, 53 adult patients with unilateral vocal fold paralysis received neck ultrasonography. Patients with laryngeal/hypopharyngeal cancer or with previously known cancers of the head and neck, thyroid, esophagus or lung, or with known etiology or trauma were excluded from this study.

Results

We included 26 men and 27 women. Ultrasonography revealed 16 patients (30%) having subclinical tumors, including thyroid papillary carcinoma in 7 patients, vagus nerve schwannoma in 2 patients, nodular goiter in 2 patients, malignant nodes in the lower neck in 4 patients, which were metastasized from lung cancer in 3 patients, esophageal cancer in 1 patient, and cervical esophageal cancer in 1 patient.

Conclusion

Neck ultrasonography is useful to detect subclinical neoplasia, causing unilateral vocal fold paralysis. Thyroid cancer is the most common neoplastic etiology of adult unilateral vocal fold paralysis. © 2011 Wiley Periodicals, Inc. Head Neck, 2012

Ancillary