[Vocal fold palsy--investigation and follow-up].
BACKGROUND
A new protocol for investigation of vocal fold palsy (VFP) was introduced in the ENT-department, Odense University Hospital on 1 January 2002. The protocol included ultrasonography (US) of the neck, x-ray of the chest and clinical examination at 3-month intervals for 1 year as well as MRI scanning of the brainstem, neck and mediastinum initially and after 6 months (or CT scanning under special circumstances). We have evaluated our protocol for investigation and in particular with regard to efficiency of diagnostic methods and the effect of long-term follow-up.


METHODS
From 1 January 2002 to 30 June 2002 we investigated 48 patients with VFP of occult origin in our department. We reviewed medical records and registered and analyzed data regarding efficiency of diagnostic methods and the effect of follow-up.


RESULTS
Ten out of 48 VFP (21%) proved to be caused by malignancy. Eight VFP had other causes and 30 were idiopathic. Nine out of ten malignant diseases were found during initial investigation. One patient was diagnosed with breast cancer and widespread metastases 10 months after initial investigation.


CONCLUSIONS
An extensive protocol for investigation of VFP is indicated. In our opinion, a protocol should include US, CT or MRI scanning of brainstem, neck and mediastinum. Our material is too limited to draw any final conclusions concerning long-term follow-up.
Mehlum
Camilla Slot
CS
Odense Universitetshospital, Øre-naese-halskirurgisk Afdeling F. camillaslot@yahoo.com
Faber
Christian Emil
CE
Grøntved
Agot Møller
AM
Andersen
Peter
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001933:Brain Stem / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging / Q000473:pathology; D009369:Neoplasms / Q000150:complications; D009422:Nervous System Diseases / Q000150:complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology