Etiology of bilateral recurrent laryngeal nerve paralysis in sudanese patients

Abstract AR

Objective: To highlight the occurrence of bilateral recurrent laryngeal nerve paralysis, a grave condition which is frequently overlooked, to reflect the author's personal experience with this condition over an l8-year period in Sudanese patients, and to identify the etiological factors involved in this condition.

Methods: Hospital records of all cases (n=28) that presented to the ENT Department of Wad Medani Teaching Hospital in Central State of Sudan over a period of l8 years (l983 - 200l) with bilateral recurrent laryngeal nerve paralysis were reviewed.

Results: The total number of patients was 28.

Twenty-five cases (25) were female while 3 were male.

The female to male ratio was 8.3:l0.

Patients' ages ranged from 27-75 years with a mean age of 43.2 years.

The symptom common to all patients was stridor on exertion.

The main etiological factor was thyroidectomy (78.6%) followed in the order of frequency by malignant tumor invasion of the nerves (l4.2%), neurological causes (3.6%), and trauma (3.6%).

Conclusion: The most common etiological factor of bilateral recurrent laryngeal nerve paralysis was found to be thyroid surgery (78.6%), followed by malignant tumor invasion of the nerves (l4.2%), neurological causes (3.6%) and trauma (3.6%).

Patients undergoing thyroid surgery should have voice and vocal cord mobility assessed by a laryngologist before and after surgery.