Iatrogenic Unilateral Vocal Fold Paralysis after Radiofrequency Lesioning for Cervical Facet Joint Denervation

•A 62-year-old female with a history of right C3-C4 facet joint disease underwent unilateral radiofrequency denervation with fluoroscopically controlled placement of the electrode under general anesthesia. She awoke with dysphagia, aphonia, and neck swelling. She had undergone prior steroid injections at C3 and C4 for management of her chronic neck pain. On initial office evaluation, she had moderate dysphonia with a phonation time of 6.5 seconds. A dense right vocal fold paralysis was noted. Her Voice Handicap Index (VHI) was 42. Aphonia persisted through the first 3 months and gradually improved with intensive voice therapy.