Hostname: page-component-6766d58669-bkrcr Total loading time: 0 Render date: 2026-05-17T00:16:08.645Z Has data issue: false hasContentIssue false
  • English
  • Français

Cervical osteophytes causing vocal fold paralysis: case report and literature review

Published online by Cambridge University Press:  29 June 2012

J S Virk ,
A Majithia ,
R K Lingam  and
A Singh
J S Virk*
Affiliation:
Department of ENT, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK
A Majithia
Affiliation:
Department of ENT, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK
R K Lingam
Affiliation:
Department of Radiology, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK
A Singh
Affiliation:
Department of ENT, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK
*
Address for correspondence: Mr Jagdeep Singh Virk, Northwick Park Hospital, Watford Road, Harrow HA1 3UJ, UK Fax: +44 (0)208 869 3098 E-mail: j_v1rk@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To increase awareness of cervical osteophytes as an extremely rare cause of recurrent laryngeal nerve palsy; to outline the clinical approach to patients with unilateral vocal fold paralysis and to provide an update on the current management of osteoarthritis and osteophytes.

Case report:

An elderly man presented with right unilateral vocal fold immobility and a small phonatory gap. By a diagnosis of exclusion, a cervical osteophyte at the level of the sixth and seventh cervical vertebrae was shown to be the cause. The patient responded to speech therapy and no further intervention was required.

Method:

A literature review, using Medline, identified only one previously published case of vocal fold paralysis due to osteophytes secondary to osteoarthritis.

Conclusion:

The aetiology of unilateral paralysis of the hemilarynx must be fully investigated, as the innervating system has a protracted course, particularly on the left side. Degenerative cervical spine disease, although rare, should be considered as part of the differential diagnosis.

Keywords

Vocal Cord ParalysisOsteophytesCervical VertebraeOsteoarthritis

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 9 , September 2012 , pp. 963 - 965
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1Yoskovitch, A, Enepekides, DJ, Hier, MP, Black, MJ. Guillain-Barré syndrome presenting as bilateral vocal cord paralysis. Otolaryngol Head Neck Surg 2000;122:269–70CrossRefGoogle ScholarPubMed
2Havas, T, Lowinger, D, Priestley, J. Unilateral vocal fold paralysis: causes, options and outcomes. Aust N Z J Surg 1999;69:509–13CrossRefGoogle ScholarPubMed
3Rosenthal, LH, Benninger, MS, Deeb, RH. Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope 2007;117:1864–70Google Scholar
4Povedano Rodriquez, V, Seco Pinero, MI, Jaramillo Perez, J. Sarcoidosis as a cause of paralysis of the recurrent laryngeal nerve. Presentation of case [in Spanish]. An Otorrinolaringol Ibero Am 1992;19:443–8Google Scholar
5Annino, DJ, MacArthur, CJ, Friedman, EM. Vincristine-induced recurrent laryngeal nerve paralysis. Laryngoscope 1992;102:1260–2CrossRefGoogle ScholarPubMed
6Merati, AL, Halum, SL, Smith, TL. Diagnostic testing for vocal fold paralysis: survey of practice and evidence-based medicine review. Laryngoscope 2006;116:1539–52Google Scholar
7MacGregor, FB, Roberts, DN, Howard, DJ, Phelps, PD. Vocal fold palsy: a re-evaluation of investigations. J Laryngol Otol 1994;108:193–6CrossRefGoogle ScholarPubMed
8El Badawey, MR, Punekar, S, Zammit-Maempel, I. Prospective study to assess vocal cord palsy investigations. Otolaryngol Head Neck Surg 2008;138:788–90Google Scholar
9Xu, W, Han, D, Hou, L, Zhang, L, Zhao, G. Value of laryngeal electromyography in diagnosis of vocal fold immobility. Ann Otol Rhinol Laryngol 2007;116:576–81CrossRefGoogle ScholarPubMed
10Wang, CC, Chang, MH, Wang, CP, Liu, SA. Prognostic indicators of unilateral vocal fold paralysis. Arch Otolaryngol Head Neck Surg 2008;134:380–8CrossRefGoogle ScholarPubMed
11Kwon, TK, Buckmire, R. Injection laryngoplasty for management of unilateral vocal cord paralysis. Curr Opin Otolaryngol Head Neck Surg 2004;12:538–42CrossRefGoogle Scholar
12Lorenz, RR, Esclamado, RM, Teker, AM, Strome, M, Scarpf, J, Hicks, D et al. Ansa cervicalis-to-recurrent laryngeal nerve anastomosis for unilateral vocal fold paralysis: experience of a single institution. Ann Otol Rhinol Laryngol 2008;117:40–5CrossRefGoogle ScholarPubMed
13Carrau, RL, Pou, A, Eibling, DE, Murry, T, Ferguson, BJ. Laryngeal framework surgery for the management of aspiration. Head Neck 1999;21:139–453.0.CO;2-P>CrossRefGoogle ScholarPubMed
14Yoskovitch, A, Kantor, S. Cervical osteophytes presenting as unilateral vocal fold paralysis and dysphagia. J Laryngol Otol 2001;115:422–4CrossRefGoogle ScholarPubMed
15Burduk, PK, Wierzchowska, M, Grzelalak, L, Dalke, K, Mierzwinski, J. Diffuse idiopathic skeletal hyperostosis inducted stridor and dysphagia. Otolaryngol Pol 2008;62:138–40CrossRefGoogle ScholarPubMed
16Lopez, AD, Mathers, CD, Ezzati, M, Jamison, DT, Murray, CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006;367:1747–57CrossRefGoogle ScholarPubMed
17Arden, N, Nevitt, MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol 2006;20:3–25CrossRefGoogle ScholarPubMed
18Nathan, M, Pope, MH, Grobler, LJ. Osteophyte formation in the vertebral column: a review of the etiologic factors – part II. Contemp Orthop 1994;29:113–19Google ScholarPubMed
19Binder, AI. Cervical spondylosis and neck pain. BMJ 2007;334:527–31CrossRefGoogle ScholarPubMed
20Kidd, BL, Langford, RM, Wodehouse, T. Arthritis and pain. Current approaches in the treatment of arthritic pain. Arthritis Res Ther 2007;9:214CrossRefGoogle ScholarPubMed
21Williams, NH, Hoving, JL. Neck Pain. In: Jones, R, Britten, N, Culpepper, L, Gass, DA, Grol, R, Mant, D et al. , eds. Oxford Textbook of Primary Medical Care. Oxford: Oxford University Press, 2004;1111–16Google Scholar
22Jagannathan, J, Sherman, JH, Szabo, T, Shaffrey, CI, Jane, JA. The posterior cervical foraminotomy in the treatment of cervical disc/osteophyte disease: a single surgeon experience with a minimum of 5 years' clinical and radiographic follow up. J Neurosurg Spine 2009;10:347–56Google Scholar
23Jagannathan, J, Shaffrey, CI, Oskouian, RJ, Dumont, AS, Herrold, C, Sansur, CA et al. Radiographic and clinical outcomes following single level anterior cervical discectomy and allograft fusion without plate placement or cervical collar. J Neurosurg Spine 2008;8:420–8CrossRefGoogle ScholarPubMed
24Radhakrishnan, K, Litchy, WJ, O'Fallon, WM, Kurland, LT. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain 1994;117:325–35Google Scholar
25Persson, LC, Carlsson, CA, Carlsson, JY. Long-lasting cervical radicular pain managed with surgery, physiotherapy, or a cervical collar. A prospective randomised study. Spine 1997;22:751–8CrossRefGoogle ScholarPubMed
26Benyamin, RM, Singh, V, Parr, AT, Conn, A, Diwan, S, Abdi, S. Systematic review of the effectiveness of cervical epidurals in the management of chronic neck pain. Pain Physician 2009;12:137–57Google Scholar
27Wang, MC, Chan, L, Maiman, DJ, Kreuter, W, Deyo, RA. Complications and mortality associated with cervical spine surgery for degenerative disease in the United States. Spine 2007;32:342–7CrossRefGoogle ScholarPubMed
28Klaassen, Z, Tubbs, RS, Apaydin, N, Hage, R, Jordan, R, Loukas, M. Vertebral spinal osteophytes. Anat Sci Int 2011;86:1–9CrossRefGoogle ScholarPubMed