Idiopathic vocal fold paralysis: Clinical course and outcomes

This investigation details the results of a retrospective chart review of 35 patients with idiopathic vocal fold paralysis. Clinical findings at presentation, as well as patient outcomes in both the short and long-term duration are comprehensively reported. Spontaneous improvement of vocal fold function was observed in 25% of patients with long-term follow up. Of those with unilateral paralysis, 27% elected to undergo surgical intervention for improvement of symptoms. Four out of the five (80%) patients with bilateral paralysis required surgical intervention, including tracheotomy to relieve severe dyspnea and stridor. Discussions regarding possible underlying, occult etiologies of idiopathic vocal fold paralysis are presented, and suggested sequential behavioral and surgical treatment strategies are introduced.