Recurrent Laryngeal Nerve Paralysis. A Review of 300 Cases

概要

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A total of 300 patients, 167 males and 133 females, with recurrent laryngeal nerve paralysis examined at the Department of Otolaryngology of Kinki University Hospital during the period from 1975 to 1988 were reviewed retrospectively. The results were as follows : (1) The age ranged from 40 to 79 years in 81 percent of the entire patients. (2) The incidence was higher for males than for females in the age group of 50 years and over. (3) The nerve was affected on the left in 187 (62.3%), on the right in 98 (32.7%) and on both sides in 15 patients (5.0%). (4) The paralysis was post-surgical in 125 patients and non-surgical in 175. The cause of paralysis was chest disease in 67, idiopathic in 48, neck disease (thyroid cancer in the majority) in 45, thyroid surgery in 40, chest surgery in 39 and endotracheal intubation in 36 patients. Chest diseases and surgeries were more frequent in males than in females whereas neck disease and thyroid surgeries were more frequent in females. (5) In 87 patients, paralysis resulted from malignant neoplasms. Forty-six of the 87 patients developed malignancies in the thorax. (6) The initial symptom of eight lung cancer, one mediastinal neoplasm, one esophageal cancer and three aneurysm cases was hoarseness. (7) Chest X-ray, CT and MRI and fluoroscopy of the esophagus were useful in detecting intrathoracic pathologies.
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