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June 1989

Bilateral Vocal Cord Paralysis With Respiratory Failure: A Presenting Manifestation of Bronchogenic Carcinoma

Author Affiliations

From the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC.

Arch Intern Med. 1989;149(6):1453-1454. doi:10.1001/archinte.1989.00390060157038

• A patient with lung cancer presented with upper airway obstruction and hypercapnic respiratory failure resulting from bilateral vocal cord paralysis. Computed tomography demonstrated tumor extension into the superior mediastinum, with probable disruption of both recurrent laryngeal nerves. Unlike the more common unilateral cord paralysis, bilateral cord dysfunction is often associated with preservation of voice and varying degrees of stridor that may lead to potentially life-threatening delays in diagnosis and treatment. Proper management requires urgent translaryngeal intubation if airway obstruction is high grade, with subsequent consideration of laryngeal surgical procedures for long-term care.

(Arch Intern Med. 1989; 149:1453-1454)

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