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November 1949

IDIOPATHIC PARALYSIS OF THE VOCAL CORD: Fixation of the Vocal Cord Without Anatomic Lesion

Arch Otolaryngol. 1949;50(5):612-615. doi:10.1001/archotol.1949.00700010626007

UNILATERAL paralysis of the vocal cord producing hoarseness and occasionally narrowing of the glottis is frequently seen by the laryngologist. In most patients with this condition the inferior laryngeal branch of the vagus nerve has been injured by an organic lesion. The left inferior laryngeal (recurrent laryngeal) nerve is more frequently affected than the right because of its greater anatomic complications. Thus, as it courses about the arch of the aorta, the recurrent laryngeal nerve becomes susceptible to pressure from an aortic aneurysm in varying degrees. Consequenly, a harsh, strident or hoarse voice as an early symptom of such a lesion brings the patient to the attention of the laryngologist, who readily recognizes the mediastinal significance of the paretic left cord. One may then complete the diagnosis by looking for a tracheal tug, abnormal surface pulsation near the sternum and roentgenographic and fluoroscopic evidence of increased aortic width.

Other causes