Beyond Surgical Injury: Systemic Etiologies of Recurrent Laryngeal Nerve Palsy

The recurrent laryngeal nerve (RLN), a branch of the vagus nerve, plays a crucial role in phonation, respiration, and airway protection. Dysfunction of the RLN can result from various factors, including trauma, surgery, endotracheal intubation, infection, and systemic diseases, leading to clinical symptoms such as hoarseness, stridor, dysphagia, and severe respiratory distress. This systematic review examines the impact of systemic diseases on RLN function. Through an analysis of cases from the English literature, the review demonstrates that RLN dysfunction in the context of systemic diseases is multifactorial, often involving complex pathophysiology. Key findings highlight that RLN dysfunction can be caused by autoimmune, inflammatory, and neurological conditions, as well as medications. The review discusses the diagnostic challenges associated with these conditions, as symptoms often overlap with other disorders, complicating accurate diagnosis. The importance of early recognition and a multidisciplinary approach to management is emphasized, with the goal of improving patient outcomes. Ultimately, increased awareness and understanding of the diverse causes of RLN dysfunction in systemic diseases are essential for effective diagnosis and management.