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Sarcoidosis Presenting as Bilateral Vocal Fold Immobility
Justin M Hintze1, Sharon H Gnagi2, David G Lott3
1Head and Neck Regeneration Program, Center for Regenerative Medicine, Mayo Clinic, Phoenix, Arizona.
Summary
Sarcoidosis can cause bilateral true vocal fold paralysis, a rare inflammatory condition. This case highlights direct granulomatous infiltration leading to immobility and the need for tracheostomy.
Area of Science:
- Otolaryngology
- Pulmonology
- Rheumatology
Background:
- Bilateral true vocal fold paralysis is uncommon, with inflammatory diseases rarely being the cause.
- Sarcoidosis is a systemic inflammatory disease that can affect various organs, including the larynx.
Observation:
- This report details the first case of sarcoidosis causing bilateral vocal fold immobility due to direct granulomatous infiltration.
- The severe vocal fold fixation necessitated tracheostomy insertion for airway management.
Findings:
- Sarcoidosis can present as vocal fold paralysis through compressive lymphadenopathy, granulomatous infiltration, and neural involvement.
- Direct granulomatous infiltration of the vocal folds can lead to severe immobility.
Implications:
- Sarcoidosis should be considered in the differential diagnosis of bilateral true vocal fold paralysis.
- Understanding the pathophysiology and presentation is crucial for timely diagnosis and management.
- This case underscores the importance of a multidisciplinary approach in managing rare sarcoidosis manifestations.
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