Progressive Vocal Fold Paralysis in Systemic Sarcoidosis Requiring Multistage Surgical Management: Case Report

Sarcoidosis-related vocal fold paralysis is rare, with bilateral involvement posing a significant airway challenge. This article describes the case of a 61-year-old woman with steroid-resistant systemic sarcoidosis who initially presented with unilateral vocal fold paralysis (UVFP) and underwent type I thyroplasty using a Gore-Tex implant. Disease progression led to bilateral vocal fold paralysis (BVFP), necessitating tracheostomy and multiple surgical interventions, including posterior cordectomy, medial arytenoidectomy, and implant removal. The post-operative outcomes demonstrated improved airway patency and functional status. This case highlights the dynamic and unpredictable nature of sarcoidosis-related airway dysfunction. Airway interventions must be tailored according to the disease stage and functional needs.