Bilateral vocal fold paralysis caused by polyarteritis nodosa.

Polyarteritis nodosa (PAN) causes necrotizing angitis mainly in medium-sized muscular arteries throughout the body, and various clinical signs and symptoms such as fever, malaise, weight loss, skin necrosis, renal failure, cerebral nervous system disorder, heart failure, and myalgia develop in affected patients. However, otolaryngologists rarely encounter patients with polyarteritis nodosa, except those with hearing-impairment or facial paralysis.1-6 A patient with PAN whose first symptom was submandibular swelling, with subsequent necrosis over a wide area of the neck and bilateral vocal fold paralysis, is presented.