Clinical and Laboratory ObservationsVincristine-induced Vocal Cord Palsy Case Report and Review of the LiteratureLatiff, Zarina Abdul MBBS, MMed, MSc*; Kamal, Nor Azlin MRCPCH*; Jahendran, Jeevanan MS (ORL-HNS)†; Alias, Hamidah MMed*; Goh, Bee See MS (ORL-HNS)†; Syed Zakaria, Syed Zulkifli MMed, PhD*; Jamal, Rahman MRCP, PhD*Author Information Departments of *Pediatrics †Otorhinolaryngology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia Reprints: Zarina Abdul Latiff, MBBS, MMed, MSc, Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia (e-mail: [email protected]). Received for publication August 25, 2009; accepted March 5, 2010 Journal of Pediatric Hematology/Oncology: July 2010 - Volume 32 - Issue 5 - p 407-410 doi: 10.1097/MPH.0b013e3181e01584 Buy Metrics Abstract Vincristine-induced vocal cord paralysis is a rare but serious complication. We report 2 patients with acute lymphoblastic leukemia who developed progressive stridor during induction chemotherapy. There were no clinical features of peripheral or autonomic neuropathy. Flexible laryngoscopy confirmed the diagnosis of bilateral vocal cord palsy; interestingly, the nerve conduction test revealed axonal motor neuropathy involving the median and common peroneal nerves in both patients. The first patient required prolonged ventilatory support necessitating unilateral cordectomy before extubation, whereas the second only required supplemental oxygen therapy. There was resolution of stridor in the first patient after cordectomy and gradual clinical improvement in the second. These cases illustrate that a high index of suspicion of vincristine-induced vocal cord palsy with prompt otolaryngology consultation for laryngoscopy is required in the diagnostic evaluation of a patient who has received vincristine. © 2010 Lippincott Williams & Wilkins, Inc.