A patient reported she was referred to an ear, nose, and throat (ent) doctor by her neurologist for evaluation of persistent hoarseness.The ent diagnosed the patient with vocal cord paresis/paralysis with the believed cause to be intubation during vns implant surgery.The patient reported that she also experiences choking, some coughing and tingling in the back of her throat.She stated that her voice is improving and she may have to undergo surgical repair.Post-implant medical records obtained from the neurologist indicate that surgery was uncomplicated, that the patient experienced a rough voice afterwards but no swallow dysfunction at that time, and that vns stimulation was well tolerated by the patient.On a subsequent visit it was noted that the patient was concerned that her voice had not come back yet.Vns parameters were increased at the visit and noted to be tolerated well by the patient, and the patient was referred to the ent.Medical records obtained from the ent describe persistent hoarseness starting immediately after vns surgery that has not worsened or improved since surgery, some dysphagia while eating & drinking, and occasional cough.Endoscopic evaluation of her larynx demonstrated left true vocal cord paresis/paralysis that appears to be complete.The ent records stated that the patient wished to continue with periodic observation and not pursue any treatment at this time.The patient was asked to return to the ent in 2 months.No known interventions have occurred to date.
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