ASPIRATION IN UNILATERAL RECURRENT LARYNGEAL NERVE PARALYSIS AFTER SURGERY

Purpose: Dysphonia with hoarseness and breathiness are the key symptom s of unilateral recurrent laryngeal nerve (RLN) paralysis, whereas asp iration is not usually described. The aim of this prospective study wa s to assess the incidence of aspiration in patients with unilateral re current laryngeal nerve paralysis after head and neck or thoracic surg ery. Patients and Methods: Five patients were included and evaluated w ithin the first week and again 2 months postoperatively. Position, ton e, and tension of the true vocal cord as well as assessment of the glo ttic axis, arytenoid position, laryngeal sensation, status of the pyri form sinus, and salivary stasis were studied. Swallowing evaluation wa s performed using flexible fiberoptic laryngoscopy during dry swallowi ng, thick cream, methylene blue liquid as well as with swallowing vide ofluoroscopy. Results: Three patients had no aspiration, one patient h ad silent aspiration, and one had symptomatic aspiration. Conclusion: We conclude that aspiration may occur in unilateral recurrent laryngea l nerve paralysis and have to be systematically evaluated after pneumo nectomy. Copyright (C) 1998 by W.B. Saunders Company.