Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics (대한후두음성언어의학회지)

The Korean Society of Laryngology, Phoniatrics and Logopedics. (대한후두음성언어의학회)
권호 표지

A Case of Unilateral Vocal Fold Paralysis Secondary to Sarcoidosis

사르코이드증에 의한 일측 성대 마비 1예

  • Lee, Oh-Hyeong (Department of Otolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea) ;
  • Bang, Jooin (Department of Otolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea) ;
  • Lee, Dohee (Department of Otolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea) ;
  • Cho, Jung-Hae (Department of Otolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea)
  • 이오형 (가톨릭대학교 의과대학 이비인후과학교실) ;
  • 방주인 (가톨릭대학교 의과대학 이비인후과학교실) ;
  • 이도희 (가톨릭대학교 의과대학 이비인후과학교실) ;
  • 조정해 (가톨릭대학교 의과대학 이비인후과학교실)
  • Received : 2019.01.16
  • Accepted : 2019.05.22
  • Published : 2019.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Vocal fold paralysis secondary to sarcoidosis is extremely rare but it can develop as a result of compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We report the case of a 56-year-old woman who presented with unilateral vocal fold paralysis and enlarged supraclavicular lymph nodes. Computed tomography of the neck revealed multiple, enlarged, and matted lymph nodes at the cervical level of IV. An ultrasound-guided core needle biopsy of the lymph node was performed, and a histopathological diagnosis of sarcoidosis was made by validating the presence of noncaseating granuloma. After implementation of steroid therapy, the patient exhibited immediate recovery from vocal fold paralysis. Although an extremely rare disease, sarcoidosis should be included in the differential diagnosis of vocal fold paralysis. Accurate diagnosis and prompt steroid treatment may reduce the morbidity of patients with vocal fold paralysis secondary to sarcoidosis.

Keywords

References

  1. Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Muller-Quernheim J. Sarcoidosis. Lancet 2014;383(9923):1155-67. https://doi.org/10.1016/S0140-6736(13)60680-7
  2. Stager SV. Vocal fold paresis: etiology, clinical diagnosis and clinical management. Curr Opin Otolaryngol Head Neck Surg 2014;22(6):444-9. https://doi.org/10.1097/MOO.0000000000000112
  3. Coffey CS, Vallejo SL, Farrar EK, Judson MA, Halstead LA. Sarcoidosis presenting as bilateral vocal cord paralysis from bilateral compression of the recurrent laryngeal nerves from thoracic adenopathy. J Voice 2009;23(5):631-4. https://doi.org/10.1016/j.jvoice.2008.01.009
  4. Mastan S, Advani R, Stobbs N, Kumar N. A rare manifestation of a multisystemic disease: a case of vocal cord palsy secondary to sarcoidosis. BMJ Case Rep doi: 10.1136/bcr-2015-209728.
  5. Jaffe R, Bogomolski-Yahalom V, Kramer MR. Vocal cord paralysis as the presenting symptom of sarcoidosis. Respir Med 1994;88(8):633-6. https://doi.org/10.1016/S0954-6111(05)80014-9
  6. Hintze JM, Gnagi SH, Lott DG. Sarcoidosis presenting as bilateral vocal fold immobility. J Voice 2018;32(3):359-62. https://doi.org/10.1016/j.jvoice.2017.05.017
  7. Lee HJ, Son JW, Choi E, Lee WY. A case of parahilar lymph node enlargement. Tuberc Respir Dis 2005;59(2):209-12. https://doi.org/10.4046/trd.2005.59.2.209
  8. Miliauskas S, Zemaitis M, Sakalauskas R. Sarcoidosis-moving to the new standard of diagnosis? Medicina (Kaunas) 2010;46(7):443-6. https://doi.org/10.3390/medicina46070063
  9. Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H Jr, Bresnitz EA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001;164(10):1885-9. https://doi.org/10.1164/ajrccm.164.10.2104046
  10. Rizzato G, Tinelli C. Unusual presentation of sarcoidosis. Respiration 2005;72(1):3-6. https://doi.org/10.1159/000083392
  11. McLaughlin RB, Spiegel JR, Selber J, Gotsdiner DB, Sataloff RT. Laryngeal sarcoidosis presenting as an isolated submucosal vocal fold mass. J Voice 1999;13(2):240-5. https://doi.org/10.1016/S0892-1997(99)80027-7
  12. Alon EE, Ekbom DC. Neurosarcoidosis affecting the vagus nerve. Ann Otol Rhinol Laryngol 2010;119(9):641-5. https://doi.org/10.1177/000348941011900913
  13. Dean CM, Sataloff RT, Hawkshaw MJ, Pribikin E. Laryngeal sarcoidosis. J Voice 2002;16(2):283-8. https://doi.org/10.1016/S0892-1997(02)00099-1
  14. Wijsenbeek MS, Culver DA. Treatment of sarcoidosis. Clin Chest Med 2015;36(4):751-67. https://doi.org/10.1016/j.ccm.2015.08.015
  15. James JC, Simpson CB. Treatment of laryngeal sarcoidosis with CO2 laser and mitomycin-C. Otolaryngol Head Neck Surg 2004;130(2):262-4. https://doi.org/10.1016/S0194-5998(03)01583-3