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Relationship between vocal cord paralysis and benign thyroid disease
M L Collazo-Clavell1, H Gharib, N E Maragos
1Division of Endocrinology, Metabolism, and Internal Medicine, Mayo Clinic, Rochester, MN 55905.
Background:
Vocal cord paralysis is generally associated with advanced thyroid malignancy. It may also be present in the setting of benign thyroid disease. This association may be incidental as well as causal.
Methods:
Retrospective review of cases with concurrent diagnosis of vocal cord paralysis and benign thyroid disease.
Results:
Eight cases found, all with documented vocal cord paralysis, by laryngoscopy. Four patients had nodular thyroid disease, but in two it was contralateral to the recurrent laryngeal nerve paralysis. The remaining patients had goiters of various sizes. Six patients were euthyroid, two on thyroid hormone replacement. Two patients were thyrotoxic: one had Graves' disease and the other had subacute thyroiditis.
Conclusions:
Vocal cord paralysis can be the result of benign thyroid disease by such mechanisms as compression, stretching, or inflammation. Malignant thyroid disease should always be ruled out in structural thyroid abnormalities. Vocal cord paralysis can also be an incidental finding unrelated to thyroid abnormality.