Vocal cord paralysis: causes, diagnosis and treatment

Vocal cord paralysis: causes, diagnosis and treatment

Vocal cord paralysis, also known as vocal cord paresis, is the inability of one or both vocal cords (vocal folds) to move.

It can greatly impact on the daily life of the sufferer, including employment, choice of job, social interactions and leisure time activities.

In this article we will look at the causes, diagnosis and treatment of vocal cord paresis.

Here are some key points about vocal cord paralysis. More detail and supporting information is in the main article.

  • Vocal cord paralysis is caused by nerve damage
  • The disease can cause a number of problems including the inability to speak
  • Choking is a hazard for people with vocal cord paralysis
  • Most often, only one of the two vocal cords are affected by vocal cord paralysis
  • Coughs and sneezes may become ineffective, allowing a build up of fluids and possible infections
  • More females than males develop vocal cord paralysis
  • Some neurological conditions, such as Parkinson's disease, raise the chances of developing vocal cord paralysis
  • Voice therapy can help in certain circumstances
  • Sometimes, no underlying cause for the condition can be found.

What is vocal cord paralysis?

Vocal cord paralysis normally only affects one of the vocal cords.

The condition is caused by damage to nerves going to the vocal cord - the nerve impulses in the larynx (voice box) are interrupted, resulting in paralysis of the vocal cord muscles. It can also be caused by brain damage.

Patients with vocal paralysis typically experience hoarseness, vocal fatigue, mild to severe reduction in speech volume, a pain in the throat when speaking, and swallowing things down the wrong way and choking.

The vocal cords, as well as allowing us to produce utterances (speak, etc.) also protect the airway, preventing food, drink and saliva from entering the trachea (windpipe). In extreme cases the resultant choking can lead to death.

Individuals with vocal cord paralysis may find the effectiveness of coughing, swallowing or sneezing in removing laryngeal area waste is undermined reduced vocal cord mobility. This may result in accumulations in the area, allowing for bacterial and viral colonization, and subsequent infections and throat discomfort.

Symptoms of vocal cord paralysis

The vocal cords consist of two bands of muscle, located at the trachea (entrance to the windpipe). When we make an utterance (produce sound from the mouth) the two bands of muscle tissue touch each other and vibrate. When we are not uttering sounds the vocal cords are in an open, relaxed position, allowing air to flow freely into our windpipe - allowing us to breathe.

Most cases of vocal cord paralysis involve just one cord being paralyzed. However, sometimes both are affected, and the patient is likely to experience swallowing as well as breathing difficulties.

Potential signs and symptoms of vocal cord paralysis include:

  • Changes to the voice - it may become more "breathy," like a loud whisper
  • Hoarseness, huskiness
  • Noisy breathing
  • Changes to vocal pitch
  • Coughs that do not clear the throat properly
  • When swallowing solids or liquids, the patient might choke (including saliva sometimes)
  • While speaking, the sufferer may have to catch their breath more often than usual
  • Voice volume may be affected - the patient may not be able to raise their voice
  • Pharyngeal reflex (gag reflex) may be lost - the pharyngeal reflex is a reflex contraction of the back of the throat, evoked by touching the soft palate. It prevents something from entering the throat except as part of normal swallowing and helps prevent choking.

Causes of vocal cord paralysis

Some neurological conditions - multiple sclerosis, Parkinson's disease - increase the risk of vocal cord paralysis.

A risk factor is something which increases the likelihood of developing a condition or disease. For example, obesity significantly raises the risk of developing diabetes type 2. Therefore, obesity is a risk factor for diabetes type 2.

The following factors may raise the chances of developing vocal cord paralysis:

  • Gender: females have a slightly higher risk than males
  • Some types of surgery: especially chest or throat surgery. Breathing tubes used in surgery may damage vocal cord nerved. Cardiac surgery represents a risk to normal voice function as the nerves serving the larynx are routed near the heart - damage to this nerve during open heart surgery is not uncommon. The recurrent laryngeal nerve also runs close to the thyroid gland making, hoarseness of voice due to partial paralysis an important side effect of thyroid surgery
  • Certain neurological conditions: people with multiple sclerosis (MS), Parkinson's disease, or myasthenia gravis have a higher risk of developing vocal cord paralysis, compared to other individuals. The risk of vocal cord weakness is greater than paralysis
  • Injury to the chest or neck: a trauma may damage the nerves that serve the vocal cords or the larynx
  • Stroke: the part of the brain that sends messages to the larynx (voice box) may be damaged from a stroke
  • Tumors: these may develop around or in the cartilages, nerves or muscles of the voice box. The tumors may be benign or malignant (cancerous)
  • Inflammation or scarring of the vocal cord joints: as well as the space between the two vocal cord cartilages may prevent the larynx from working properly. Although the cord nerves are usually working correctly, the inflammation can give vocal cord paralysis-like signs and symptoms. Some infections may also cause inflammation.
Vocal cord paralysis may also be idiopathic - there may be no identifiable cause.

On the next page, we look at the diagnosis and treatment of vocal cord paralysis.

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VOCAL CORD PARALYSIS Symptoms and Treatments (Video Medical And Professional 2020).

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