Clinical applicability of the study
To date this is the first UK based study and the largest case series reporting vocal cord paralysis secondary to vincristine chemotherapy. As cases that are referred to ENT are likely to be more severe cases in terms of symptoms at presentation, it is likely that there is under reporting, particularly of symptoms of unilateral paralysis. As symptoms resolve on cessation of vincristine, early detection of mild symptoms such as hoarseness via a prompt referral for diagnostic laryngoscopy is essential. This may prompt alteration of treatment and may possibly prevent the progress to more life threatening bilateral paralysis requiring tracheostomy.