Tuberculous left vocal cord palsy: a timely reminder

Although the possible aetiologies of vocal cord palsy are many, most cases can be classified into a few major categories. In a large review to patients with this problem from the Mayo Clinic (Clerf, 1953), 43 per cent followed thyroid surgery. In current clinical practice, in the absence of surgical trauma, a patient presenting with a left vocal cord palsy would be considered to be suffering from a pulmonary or mediastinal malignancy until proven otherwise. Even when pulmonary tuberculosis was relatively common, vocal cord palsy from this cause was rare, occurring in less than 1 per cent of cases (Gupta, 1960). Nowadays it is thus an exceedingly rare, but nonetheless important, diagnosis to make, and we wish to report a case of left vocal cord palsy presumably caused by involvement of the left recurrent laryngeal nerve in caseous necrosis of mediastinal nodes.