Unilateral vocal cord palsy during COVID-19 era: a study from a tertiary care centre in India

Abstract

Abstract Background In otolaryngology outpatient clinics, patients frequently present with unilateral vocal cord paralysis (UVCP). During the pandemic, various new protocols were designed to identify UVCP. An experienced otolaryngologist must conduct a thorough history-taking, examination, and investigation to determine the cause of UVCP. Objectives To evaluate various causes of UVCP during the pandemic. Methods Thirty patients with UVCP on 70-degree rigid endoscopy were studied. Detailed general and systemic examinations were done. All COVID-19 precautions were followed during the evaluation, and real-time reverse transcription-polymerase chain reaction was done before the endoscopic procedure. High-resolution computed tomography scan of skull base to mediastinum with contrast was performed for etiology. Patients were treated according to the standard protocols. Follow-up at 1, 3, and at 6 months was performed. Results The mean age was 42.3 ± 14.83 years. All the patients had presented with a change in voice. Twenty percent had UVCP post a surgical procedure. No cause could be found in 16.67% of patients. Five patients had succumbed to complications relating to their other prevailing conditions. At 6 months, 10 patients continued to have palsy, 9 showed paresis, and 6 showed complete mobility of the cords. Conclusion During the pandemic, diagnosing and following up such patients were a challenge. Investigating a cause of UVCP, the symptoms of which might be trivial at presentation, leads to discover a much sinister cause. UVCP in post-covid mucormycosis was an entity requiring multimodality management. Pandemic-induced restrictions lead to formulations of newer protocols for tackling this entity.

Keywords

• 70-degree endoscopy
• COVID-19 pandemic
• Hoarseness of voice
• Personal protection equipment
• Post-COVID mucormycosis
• Unilateral vocal cord palsy