Post-traumatic Delayed Bilateral Vocal Cord Paralysis Caused by Cervical Osteophytes: A Case Report

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 7; p. e64189
• Main Authors: Yamaguchi, Takuya, Itagaki, Hideya, Endo, Tomoyuki
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 09.07.2024
• Subjects: Airway management; Biochemistry; Blood tests; Case reports; Consciousness; Contusions; Dysarthria; Dysphagia; Dyspnea; Emergency medical care; Fainting; Fractures; Hematoma; Hemoglobin; Kinases; Medical imaging; Neck; Ostomy; Paralysis; Tracheotomy; Trauma; airway emergency; vocal cord paralyses; multiple head injury; bilateral vocal cord paresis; osteophytes
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.64189

Vocal fold paralysis occurs when the function of the vagus nerve or its distal branch, the recurrent laryngeal nerve, is diminished or absent. Bilateral vocal fold paralysis can present with varying degrees of severity and is sometimes fatal. Cervical osteophytes are a rare cause of bilateral vocal fold paralysis, with only a few cases reported. A 68-year-old man was brought to the emergency department because of a disturbance in consciousness following a fall. A CT scan of the head showed multiple cranium and brain injuries, and the patient was treated conservatively by neurosurgery. The day after the injury, dysphagia and dysarthria appeared. On the third day of admission, both vocal cords were fixed bilaterally in the paramedian position, and the patient was nearly choking on sputum. A CT scan showed that the intracranial lesions gradually improved, but the vocal cord paralysis remained. A cervical CT scan was performed to investigate the cause of the vocal cord paralysis, which revealed that cervical vertebral osteophytes were compressing the tracheoesophageal groove and the glottis. The patient was transferred to the hospital for rehabilitation, although bilateral vocal cord paralysis remained. Although rare, clinicians need to be aware that cervical osteophytes can cause vocal fold paralysis, which may be manifested when combined with further trauma. It is also important to note that traumatic vocal cord paralysis can be delayed.