title: [Isolated unilateral laryngeal nerve paralysis in adults. An inception cohort of 591 patients managed in a French--university--teaching hospital].
abstract: We analyzed an inception cohort of 591 adults with isolated unilateral laryngeal paralysis managed at a French teaching hospital during the period 1990-2008. Symptoms, causes, treatment and outcome were compared between two periods (1990-2000 vs 2001-2008), using the Chi squared test and Mann Whitney U test. Dysphonia, swallowing impairment and respiratory impairment were present in respectively 98.3%, 34.8% and 4.1% of cases, The causes of paralysis were surgical and non surgical in respectively 65.1% and 21.1% of cases. Cancer (mainly lung cancer) was present in 59.6% of cases, and 22% of these patients were receiving palliative treatment. Thoraco-mediastinal surgery and thyroid-parathyroid surgery accounted for 79.4% of surgical causes. Malignancies accounted for 76.8% of non surgical causes. Within the idiopathic group (13.8% of the cohort), a tumor lying along the path of the paralyzed nerve was detected in 3.7% of cases. Larynx motion was recovered in 19.6% of cases; nerve transection, the etiology, and the time since symptom onset were predictive factors for motion recovery. Treatment consisted of laryngeal medialisation and isolated speech therapy in 40.1% and 59.9% of cases, respectively. The current success rate of laryngeal medialisation is 90.3%.
  
  
  CONCLUSIONS
  The three main causes of unilateral laryngeal nerve paralysis were tumors, surgery and cardiovascular disorders (surgical and non surgical). Laryngeal medialisation is now a major component of rehabilitation in our center.
authors.affiliation: Oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Européen Georges Pompidou, 20-40 rue Leblanc 75015 Paris cedex, France. ollivier.laccourreye@egp.aphp.fr
authors.forename: Ollivier
authors.initials: O
authors.lastname: Laccourreye
authors.forename: Benoit
authors.initials: B
authors.lastname: Delas
authors.forename: Pierre
authors.initials: P
authors.lastname: Bonfils
authors.forename: David
authors.initials: D
authors.lastname: Malinvaud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D005602:France; D006784:Hospitals, Teaching; D006801:Humans; D007823:Laryngeal Nerves; D008297:Male; D008875:Middle Aged; D055815:Young Adult