ABSTRACT
The cause for the paralysis can be considered by following the paired nerves involved: vagus, superior laryngeal nerve and the recurrent laryngeal nerve. The technical description of a Vocal fold paralysis (VFP) requires a proven electromyography pattern. The main regions where surgery is undertaken and potential nerve injury exists are neck surgery, thoracic surgery and skull base surgery. Thyroid surgery remains the single most common surgical procedure complicated by unilateral VFP, comprising 14–67% of all surgical regions. The incidence of temporary or permanent VFP from thyroid surgery alone is 1–7.7%. The temporary paralysis rate is 1–5.1% and the permanent paralysis rate is 1–8.6%. Surgery involving the aortic arch, coronary artery bypass grafting, hilum of the lung, mediastinum or oesophagus can be complicated by VFP with up to 41% of such surgery reporting potential nerve injury. In this setting, patients may be intubated for a variable postoperative period so such injury may only be noted on extubation.
