Background: An extralaryngeal neoplasm involving the vagus nerve and recurrent laryngeal nerve must be excluded when adult unilateral vocal fold paralysis is diagnosed.
Methods: Between 2004 and 2009, 53 adult patients with unilateral vocal fold paralysis received neck ultrasonography. Patients with laryngeal/hypopharyngeal cancer or with previously known cancers of the head and neck, thyroid, esophagus or lung, or with known etiology or trauma were excluded from this study.
Results: We included 26 men and 27 women. Ultrasonography revealed 16 patients (30%) having subclinical tumors, including thyroid papillary carcinoma in 7 patients, vagus nerve schwannoma in 2 patients, nodular goiter in 2 patients, malignant nodes in the lower neck in 4 patients, which were metastasized from lung cancer in 3 patients, esophageal cancer in 1 patient, and cervical esophageal cancer in 1 patient.
Conclusion: Neck ultrasonography is useful to detect subclinical neoplasia, causing unilateral vocal fold paralysis. Thyroid cancer is the most common neoplastic etiology of adult unilateral vocal fold paralysis.
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