Treatment of bilateral vocal cord paralysis
Late diagnosis of a vocal cord paralysis may lead to a legal case, but in fact it is not very likely that such late diagnosis will cause serious harm to the patient. This is because tumours of the lung or upper oesophagus producing such a vocal cord paralysis are essentially inoperable by the time the hoarseness has developed. In the same way, an advanced tumour of the neck which has paralysed the vagus nerve is not likely to be amenable to successful treatment. Neurological tumours (such as large acoustic neuromas-Chapter 25) are unlikely to be missed in this context because other cranial nerves apart from the vagus will be involved. If, however, fixation of one vocal cord caused by a tumour within the larynx is overlooked, this can have serious consequences, and failure of the laryngologist to make such a diagnosis is not acceptable.