The prognosis and management of idiopathic vocal cord paralysis

If a vocal cord paralysis is termed idiopathic, no cause has been identified. The aim of this study was to assess the prognosis and management of patients with an idiopathic vocal cord paralysis. Data of 42 such patients have been stored prospectively. During follow-up 4 patients were found to have malignancies that in retrospect had been responsible for their vocal cord paralysis. Of the remainder approximately half either recovered vocal cord function or regained a near normal voice due to compensatory movement by the non-paralysed cord. No patient over the age of 60 compensated. No patient either recovered vocal cord function or compensated more than 12 months after the onset of his paralysis. In conclusion, patients with an idiopathic vocal cord paralysis should be suspected of harbouring a malignancy unless vocal cord mobility recovers, and management of the laryngeal dysfunction should be expectant for up to 12 months.