Localization Examination of the Vagus Nerve in Determining the Cause of the Unilateral Vocal Cord Paralysis
LI Jin-rang
ZHAO Dan-heng
Abstract：Objective To evaluate the value of localization examination of the vagus nerve in determining the cause of the unilateral vocal cord paralysis. Methods The diagnostic process of a patient with unknown cause of unilateral vocal cord paralysis was retrospectively reviewed. Results The patient presented to our center for hoarseness for half a year. Idiopathic left side vocal cord paralysis was diagnosed because no positive findings were detected in many hospitals. After corresponding treatment, the vocal cord paralysis had no sign of recovery, and then the patient came to our hospital for improving his voice by autologous fat injection into the vocal fold. After medical history collection and careful physical examinations, the patient underwent electronic fibrolaryngoscope swallow study and the result showed residual food in the left pyriform sinus. Those find-ings suggested that damaged level of the vagus nerve was above the ganglion of the vagus nerve. Contrast enhanced MRI of the skull base found a mass in the jugular foramen region, considered as benign tumor. The patient refused surgical treatment and received gamma knife radiosurgery. The tumor was not changed in the 1-year follow-up. Conclusion Patients with unilateral vocal cord paralysis should not be diagnosed as vocal cord paralysis simply. The electronic fibrolaryngoscope swallow study is helpful for determining the impaired site of the vagus nerve. Then, examination should be focused on the impaired site, and the cause of the vocal cord paralysis may be found.
Keywords：Vocal cord paralysisVagus nerve injuriesElectronic laryngoscopeSwallow functionSkull base neo-plasmsMissed diagnosis
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 19-21 )