VOCAL FOLD PALSY FOLLOWING VINCA ALKALOID TREATMENT

We report two patients with Hodgkin's disease on chemotherapy, one wit h vincristine, the other with vinblastine, who were referred to the EN T department with a vocal fold palsy. These drugs are commonly used in the treatment of haematological malignancies, and head and neck sarco mas. Examination showed a unilateral immobile fold. No causative local pathology was identified, and they were otherwise thought to be achie ving remission, but the development of a fold palsy suggested a poor r esponse to treatment. One patient's palsy resolved following completio n of chemotherapy, but the other patient's persists, despite an otherw ise good response to the treatment. The vinca alkaloids are neurotoxic , usually causing a peripheral neuropathy, but cranial mononeuropathie s are a rare side-effect. A total of 27 previous cases of vocal fold p alsy have been reported with the use of the vinca alkaloids, and such a lesion should not be assumed to be due to advancing lymphoma.