Recurrent laryngeal nerve paralysis. A 10-year review of 564 patients

A retrospective review of the clinical records of 564 patients with recurrent laryngeal nerve paralysis examined at the Department of Otolaryngology, Kurume University Hospital during the 10-year period from 1971 to 1980 was completed. The results are summarized as follows: 1) Two-hundred and ninety-three patients were male and 271, female. The incidence was high in old age groups. 2) Idiopathic paralysis (233 cases) was the most frequent and paralysis caused by thyroid surgery (68 cases) and endotracheal intubation (63 cases) came next. 3) The lesion was unilateral in 519 patients (right to left = 148 to 371) and bilateral in 45. 4) The paralytic vocal fold was fixed in the paramedian position in the majority of the patients. A limited movement of the paralytic fold was observed in some cases, especially those of paralysis caused by endotracheal intubation and idiopathic paralysis. 5) A compensatory overcrossing of the unaffected vocal fold was found in 41 patients. It developed within six months from the onset in most cases. 6) Spontaneous recovery and improvement of mobility took place in 54 of the 165 patients who could be followed up for 1 year or longer. Paralysis caused by endotracheal intubation showed the best prognosis and idiopathic paralysis came next. 7) Spontaneous voice recovery and improvement occurred in 183 of the 240 patients whose voice outcome was determined. 8) Phonosurgical treatments yielded good results in most cases. Some patients, however, had their voice receded later.