title: Causes of recurrent laryngeal nerve paralysis.
abstract: OBJECTIVE
  Persistent hoarseness due to recurrent laryngeal nerve paralysis (RLNP) reduces the quality of life unless it is adequately treated. This study examined the indications for phonosurgical intervention in patients with RLNP.
  
  
  METHODS
  The medical records of the Ehime University Hospital, Ehime, Japan, from October 1976 until December 1997 were reviewed retrospectively to identify patients with RLNP. The data collected included age, gender, paralyzed side, and cause of paralysis.
  
  
  RESULTS
  Four hundred and sixty-six patients with RLNP were identified: 262 males and 204 females. Unilateral RLNP was present in 422 patients, while 44 presented with bilateral RLNP. The incidence was relatively high in the 7th and 8th decades, and was twice as high in male patients as in female patients. The 466 patients were divided into 2 groups: Group 1 included 225 patients seen before January 1987, and Group 2 included 241 patients seen after this date. The number of patients with postoperative RLNP was significantly higher in Group 2 (124 of 239 patients) than in Group 1 (65 of 227 patients) (P<0.05). Surgery for cardiovascular disease, esophageal cancer, and skull base and thyroid gland tumors contributed to this increased incidence of postoperative RLNP.
  
  
  CONCLUSIONS
  Patients with persistent unilateral RLNP require appropriate treatment for hoarseness, regardless of its cause. Since the incidence of RLNP related to surgery was significantly increased in Group 2, phonosurgery has become more important for improving the quality of life of these patients.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan. yumoto@gpo.kumamoto-u.ac.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Yumoto
authors.forename: Ryosei
authors.initials: R
authors.lastname: Minoda
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Hyodo
authors.forename: Takahiko
authors.initials: T
authors.lastname: Yamagata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery