Cervical osteophytes causing vocal fold paralysis: case report and literature review.
OBJECTIVE
To increase awareness of cervical osteophytes as an extremely rare cause of recurrent laryngeal nerve palsy; to outline the clinical approach to patients with unilateral vocal fold paralysis and to provide an update on the current management of osteoarthritis and osteophytes.


METHODS
An elderly man presented with right unilateral vocal fold immobility and a small phonatory gap. By a diagnosis of exclusion, a cervical osteophyte at the level of the sixth and seventh cervical vertebrae was shown to be the cause. The patient responded to speech therapy and no further intervention was required.


METHODS
A literature review, using Medline, identified only one previously published case of vocal fold paralysis due to osteophytes secondary to osteoarthritis.


CONCLUSIONS
The aetiology of unilateral paralysis of the hemilarynx must be fully investigated, as the innervating system has a protracted course, particularly on the left side. Degenerative cervical spine disease, although rare, should be considered as part of the differential diagnosis.
Department of ENT, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK. j_v1rk@hotmail.com
J S
JS
Virk
A
A
Majithia
R K
RK
Lingam
A
A
Singh
D000369:Aged, 80 and over; D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D055154:Dysphonia / Q000209:etiology / Q000628:therapy; D006685:Hoarseness / Q000209:etiology / Q000628:therapy; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D010003:Osteoarthritis / Q000150:complications*; D054850:Osteophyte / Q000150:complications* / Q000000981:diagnostic imaging; D013070:Speech Therapy; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy