1795
Etiologies:neoplastic 35%, surgical 25%, idiopathic 15%, inflammation 12%, central 7% and trauma 6%.
Vocal cord paralysis: Treatment and more
Vocal cord paralysis, also known as vocal cord paresis.
Refers to the inability of one or both vocal cords to move.
Most cases of vocal cord paralysis involve just one cord being paralyzed.
If both are affected, and the patient is likely to experience swallowing as well as breathing difficulties.
The vocal cords consist of two bands of muscle, located at the trachea.
With the production of sound from the mouth, the two bands of muscle tissue touch each other and vibrate.
Vocal cord paralysis is caused by nerve damage.
When the nerve impulses in the larynx are int2242upted, paralysis of the vocal cord muscles result.
Brain damage can cause VC paralysis.
Multiple sclerosis, and Parkinson’s disease increase the risk of vocal cord paralysis.
Trauma to the neck or chest may damage the nerves that serve the vocal cords or the larynx.
Brain damage from stroke may cause neurological damage to the nerves of the larynx.
The presence of masses around or in the cartilages, nerves or muscles of the voice box,ay cause vocal cord paralysis.
Inflammation or scarring of the vocal cord joints, although the cord nerves are usually working correctly.
Other risk factors for vocal cord paralysis include:
Some types of surgery: especially chest or throat surgery.
Breathing tubes used in surgery may damage vocal cord nerved.
Cardiac surgery
Thyroid surgery
It may also be idiopathic.
Manifests as problems including the inability to speak, coughs and sneezes may become ineffective.
It may allow a build-up of fluids and possible infections in the larynx.
Generally only affects one of the vocal cords.
Patients usually experience hoarseness, voice fatigue, reduction in speech volume, pain in the throat when speaking, and swallowing things down the wrong way and choking.
The vocal cords allow the production pf utterances such as speech.
The vocal cords protect the airway, preventing food, drink, and saliva from entering the trachea.
Vocal cord paralysis may decrease effectiveness of coughing, swallowing or sneezing in removing waste from the larynx, resulting in accumulations of bacterial and viruses and subsequent infections and throat discomfort.
Treatment depends on cause, severity of symptoms, and how long they have been present.
Treatment may include voice therapy, surgery, or both.
Voice therapy is the equivalent of physical therapy: activities to strengthen vocal cords, improve their breath and control while speaking, prevent unusual tensions in other muscles near the affected vocal cord(s), and protect the airway from liquids and solids.
Surgical options:
injection of fat, collagen or some filler into the vocal cord with extra bulk bringing the vocal cord nearer to the middle of the larynx, making it easier for the opposite cord muscle to move effectively when the patient coughs, swallows or speaks.
Phonosurgery- the repositions and/or reshapes the vocal fold to improve voice functions.
Tracheotomy – if both vocal cords are affected and very close to each other, breathing will be more difficult because of decreased air flow.
When one is silent the vocal cords are in an open, relaxed position, allowing air to flow freely into the windpipe .
Signs and symptoms of vocal cord paralysis include:
Changes to the voice
Hoarseness, huskiness
Noisy breathing
Changes to vocal pitch
Coughs that do not clear the throat properly
Choking when swallowing solids or liquids.
Breathlessness while speaking.
Voice volume may be affected.
The pharyngeal reflex may be lost.
Complications of VC paralysis:
Breathing problems
Aspiration
Diagnostic tests that help in diagnosis:
Endoscopy to look at the vocal cords., including videostrobolaryngoscopy.
Laryngeal electromyography (LEMG) – electric currents in the larynx muscles are measured.
X-rays, CT scans, MRI scans to help determine the cause of the paralysis.