Aspiration in unilateral recurrent laryngeal nerve paralysis after surgery

Purpose: Dysphonia with hoarseness and breathiness are the key symptoms of unilateral recurrent laryngeal nerve (RLN) paralysis, whereas aspiration is not usually described. The aim of this prospective study was to assess the incidence of aspiration in patients with unilateral recurrent laryngeal nerve paralysis after head and neck or thoracic surgery. Patients and Methods: Five patients were included and evaluated within the first week and again 2 months postoperatively. Position, tone, and tension of the true vocal cord as well as assessment of the glottic axis, arytenoid position, laryngeal sensation, status of the pyriform sinus, and salivary stasis were studied. Swallowing evaluation was performed using flexible fiberoptic laryngoscopy during dry swallowing, thick cream, methylene blue liquid as well as with swallowing videofluoroscopy. Results: Three patients had no aspiration, one patient had silent aspiration, and one had symptomatic aspiration. Conclusion: We conclude that aspiration may occur in unilateral recurrent laryngeal nerve paralysis and have to be systematically evaluated after pneumonectomy. Copyright (C) 1998 by W.B. Saunders Company.