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Sarcoidosis presenting as bilateral vocal fold paralysis
1Section of Otolaryngology--Head and Neck Surgery, Department of Surgery, Christiana Care Health Services, Newark, Delaware, USA. robertlwitt@aol.com
Summary
Sarcoidosis can cause vocal fold paralysis by affecting nerves or the larynx. This case highlights sarcoidosis as a rare cause of bilateral vocal fold paralysis, responding well to steroid treatment.
Area of Science:
- Neurology
- Otolaryngology
- Pulmonology
Background:
- Sarcoidosis is an inflammatory disease that can affect multiple organs.
- Laryngeal involvement in sarcoidosis can lead to vocal fold dysfunction.
- Previous reports infrequently linked sarcoidosis to unilateral vocal fold paralysis.
Observation:
- This report details a rare case of sarcoidosis causing bilateral vocal fold paralysis in the abducted position.
- The patient presented with cranial polyneuritis and mediastinal granulomatous compression.
- Bilateral paratracheal and mediastinal adenopathy were noted as contributing factors.
Findings:
- Sarcoidosis-induced cranial polyneuritis and mediastinal compression led to bilateral vocal fold paralysis.
- The patient experienced a significant improvement in vocal fold function following steroid therapy.
- This case expands the known laryngeal manifestations of sarcoidosis.
Implications:
- Sarcoidosis should be considered in the differential diagnosis of both unilateral and bilateral vocal fold paralysis.
- Early recognition and treatment of neurosarcoidosis impacting the larynx are crucial for patient outcomes.
- This case underscores the importance of a multidisciplinary approach in managing complex sarcoidosis presentations.