Vocal cord paralysis in 100 hoarse patients examined through flexible fibreoptic nasopharyngoscope/ laryngoscope

Aim: to evaluate the role of flexible fibreoptic nasopharyngocope /laryngoscope in diagnosis of vocal cords paralysis to help in proper management of the patients . study design: this study is a retrospective case series in which 100 outpatients who presented with hov were reviewed. setting: ent unit-1 mayo hospital,king edward medical university (kemu),lahore period: from sep 2012 to march 2013. methods: patients were admitted through ent outpatient department. the data was collected on the basis of history,physical examination,investigations,flexible fibreoptic nasopharngoscopy/ laryngoscopy findings,management and follow up was done through standard questionnaire. result: 100 patients suffering from laryngeal pathologies who presented with hov were 70 (70%) male and 30(30%) female between 10 to 80 years of age. the highest incidence was seen in males (70%). 10% patients diagnosed with vocal cords paralysis. male to female ratio was equal 1:1.average age of the patients diagnosed with vocal cord paralysis (vcp) was 43.3 years.among those diagnosed with vcp,six patients were suffering from left vocal cord,three from right vocal cord and one from bilateral vocal cords paralysis. overall 90% (n=10) were suffering from unilateral vocal cord paralysis (uvcp) and 10(10%) from bilateral vocal cord paralysis (bvcp). four patients with suspected tb were referred to pulmonology department for further investigations. d/l biopsy done in two patients. urgent tracheostomy done in one patient diagnosed with bvcp. conclusion: flexible fibreoptic nasopharngoscopy /laryngosopy is a safe,noninvasive and best procedure for diagnosis of vocal cord paralysis,nasal,pharyngeal and other laryngeal pathologies. hoarseness of voice (hov) is a significant presenting complaint of vocal cord paralysis and should not be ignored if proceed beyond 3 weeks,which was not responding to conventional treatment.