Unilateral vocal fold paralysis as a port complication

Area of Science:

• Otorhinolaryngology
• Vascular Surgery
• Oncology

Background:

• Unilateral vocal fold paralysis (UVFP) is common, but port-related complications are rare.
• Totally implantable venous-access ports are used for long-term chemotherapy and other treatments.
• Iatrogenic causes of UVFP are diverse, requiring careful differential diagnosis.

Observation:

• A 55-year-old woman with pancreatic adenocarcinoma developed left UVFP.
• The UVFP occurred concurrently with left subclavian vein thrombosis.
• A totally implantable venous-access port had been previously placed in the left subclavian vein.

Findings:

• This case presents the first reported instance of irreversible UVFP associated with onsite thrombosis of a port-implanted vessel.
• The patient's oncologic condition initially suggested a neoplastic cause for the UVFP.
• The findings point to an unusual iatrogenic etiology secondary to the venous-access port.

Implications:

• This case underscores the importance of considering port complications in the differential diagnosis of UVFP, even in cancer patients.
• Awareness of this rare complication can guide timely diagnosis and management of iatrogenic vocal fold paralysis.
• Further investigation into the mechanisms of iatrogenic UVFP related to venous access devices is warranted.