Vocal Cord Paralysis Analysis of 229 Cases

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Abstract
To the Editor.— Vocal cord paralysis may be congenital or acquired, unilateral or bilateral, of sudden or gradual onset, and may occur at any age from the cradle to the grave. Cunning estimated that approximately 10% of the cases of unilateral cord paralysis "are caused by some intracranial disease before the nerve leaves the skull such as tumor, abscess, bulbar paralysis or vascular accidents," and about 90% "are caused by peripheral lesions along the course of the vagus or recurrent laryngeal nerve."1When a vocal cord is paralyzed in the median-paramedian position there is a complete paralysis of the recurrent (inferior) laryngeal nerve; and when a cord is paralyzed in the intermediate position there is a complete paralysis of both the recurrent and superior laryngeal nerves. The otolaryngologist is frequently asked to determine the cause of cord paralysis. A battery of examinations which may reveal the cause includes (1)

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