[Unilateral laryngeal paralyses: epidemiological data and therapeutic progress].
OBJECTIVE
Analysis of the epidemiology and progress in treatment of unilateral laryngeal nerve paralysis.


METHODS
A retrospective study in a cohort of 325 patients (1989-2001) with unilateral laryngeal nerve paralysis.


RESULTS
The sex ratio was 1:2. Age varied from 16 to 98 years (mean age: 55 years). Symptoms included dysphonia in 321 patients, swallowing impairment in 126 patients and dyspnea on exertion in 3 patients. Etiologies were post-surgical (243 patients) predominantly thyroid and thoraco-mediastinal surgery, idiopathic (39 patients), tumoral (28 patients), non-surgical traumatism (8 patients) and medical causes (7 patients). The paralysis was globally related to a neoplastic disease in 50% of cases. Analysis of the evolution of the etiologies over time revealed an increase in the post surgical causes and paralysis related to a neoplastic diseases. Spontaneous recovery of unilateral laryngeal nerve paralysis occurred in 23% of patients. Surgical rehabilitation was performed in 44% of patients (thyroplasty under local anesthesia in 55 patients and intracardal injection under general anesthesia in 88 patients). The analysis of the evolution of treatment modalities showed: an increasing number of patients undergoing surgical rehabilitation, an increasing number of patients undergoing surgery under local anesthesia (thyroplasty) and an increasing number of patients refusing any surgical rehabilitation.


CONCLUSIONS
Analysis of the data underlined the changes in the distribution of the etiologies and treatments of unilateral laryngeal nerve paralysis.
Laccourreye
Ollivier
O
Service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, Hôpital européen Georges Pompidou, AP-HP Université Paris V, Paris. ollivier.laccourreye@hop.egp.ap-hop-paris.fr
Papon
Jean-François
JF
Kania
Romain
R
Ménard
Madeleine
M
Brasnu
Daniel
D
Hans
Stéphane
S
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D011159:Population Surveillance; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012009:Recurrent Laryngeal Nerve; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013896:Thoracic Diseases / Q000150:complications / Q000601:surgery; D013899:Thoracic Neoplasms / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*