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Cervical osteophytes causing vocal fold paralysis: case report and literature review

Published online by Cambridge University Press:  29 June 2012

J S Virk*
Affiliation:
Department of ENT, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK
A Majithia
Affiliation:
Department of ENT, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK
R K Lingam
Affiliation:
Department of Radiology, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK
A Singh
Affiliation:
Department of ENT, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK
*
Address for correspondence: Mr Jagdeep Singh Virk, Northwick Park Hospital, Watford Road, Harrow HA1 3UJ, UK Fax: +44 (0)208 869 3098 E-mail: [email protected]

Abstract

Objectives:

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.

Case report:

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.

Method:

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

Conclusion:

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.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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