Reversible recurrent laryngeal nerve palsy in acute thyroiditis

Area of Science:

• Otolaryngology
• Endocrinology
• Thyroidology

Background:

• Unilateral vocal cord paralysis (UVCP) is typically associated with malignant thyroid disease and has a poor prognosis for vocal cord function recovery.
• While rare in benign thyroid conditions, UVCP can occur, often leading to the assumption of an irreversible lesion.

Observation:

• A 54-year-old woman presented with UVCP following a right hemithyroidectomy for a benign thyroid nodule.
• The patient experienced an episode of subacute thyroiditis, a condition not commonly linked to UVCP.

Findings:

• The patient received intravenous antibiotics and underwent a completion thyroidectomy.
• Post-operatively, the patient demonstrated successful recovery of vocal cord function.

Implications:

• This case demonstrates that UVCP associated with thyroiditis, even in a post-surgical patient, can be reversible.
• Treatment with steroids and antibiotics, alongside careful surgical technique to preserve the recurrent laryngeal nerve, is crucial for managing UVCP in thyroid disease.