Histopathology of vocal cord palsy from recurrent laryngeal nerve damage

The detailed postmortem laryngeal findings of a man with an established vocal cord palsy from an inoperable bronchial carcinoma is presented. Fine dissection of the monoblock specimen from skull base to superior mediastinum allowed sampling of vagus, recurrent and superior laryngeal nerves at different levels for fiber counts in order to compare the affected left and unaffected right side. Horizontal slicing of the whole larynx showed that the main cause of lateral displacement of the paralyzed left cord was gross atrophy of the underlying intrinsic laryngeal muscles. Cricothyroid muscle and superior laryngeal nerves were unaffected. Lateral cord drift due to underlying muscle atrophy is a better explanation of paralyzed cord position in this case than the Wagner and Grossmann theory of cord palsy.