Palliative surgery for neoplastic unilateral vocal cord paralysis.
BACKGROUND
Locally advanced, recurrent or metastatic neoplasms are the commonest causes of unilateral vocal cord paralysis (UVCP). The aim of the present study was to evaluate both survival and results of treatment of vocal cord medialization procedures in this group of patients.


METHODS
Fifty-seven patients (36 male, 21 female) with UVCP considered to be due to advanced malignancy who underwent medialization (Teflon injection or type I thyroplasty) between January 1994 and July 2000 were retrospectively reviewed.


RESULTS
The malignancy responsible for UVCP was non-small-cell lung carcinoma (NSCLC) in 43 patients, small-cell lung carcinoma (SCLC) in four patients, thyroid carcinoma in three patients and metastatic lower cervical lymph nodes in seven patients. All patients complained of dysphonia and 29 patients had symptoms of aspiration. Teflon injection was performed in 44 patients and thyroplasty in 13. Improvement in voice occurred in 51 patients (89%) and resolution of aspiration in 28 patients (97%) after 2 months. The median time from onset of symptoms of UVCP to death in NSCLC was 170 days; SCLC, 69 days; thyroid carcinoma, 783 days; and metastatic lower cervical lymph nodes, 304 days.


CONCLUSIONS
Surgical treatment of neoplastic UVCP provides satisfactory palliation of symptoms, and management decisions should be based on patient survival expectations.
Iseli
T A
TA
Department of Otolaryngology, Head and Neck Surgery, Royal Melbourne Hospital and Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia. iselitim@hotmail.com
Brown
C L
CL
Sizeland
A M
AM
Berkowitz
R G
RG
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications; D018288:Carcinoma, Small Cell / Q000150:complications; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care; D011138:Polytetrafluoroethylene; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000150:complications; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D014827:Vocal Cords / Q000601:surgery
D011138:Polytetrafluoroethylene