Vocal cord paralysis

Vocal cord paralysis happens when you can’t control the muscles that move one or both vocal cords. Vocal cords that can’t close may leave a space for food, fluids and saliva (spit) to enter your windpipe and lungs. Problems with breathing, swallowing and speaking can result. Healthcare providers treat this condition with voice therapy and surgery.

Vocal cord paralysis, or vocal fold paralysis, occurs when the normal movement of one or both vocal cords is compromised. These muscular bands within the larynx, situated atop the trachea, are vital for functions like breathing, swallowing, and vocalizing. Nerve damage disrupts the coordinated opening and closing of these cords, leading to challenges in speaking, swallowing, and even breathing.

Vocal cord paralysis presents as either unilateral (affecting one vocal cord) or bilateral (affecting both vocal cords). Unilateral cases typically result in speech or swallowing difficulties, while bilateral paralysis can narrow the airway dangerously, posing potential life-threatening risks if untreated.

Prevalence of Vocal Cord Paralysis

Unilateral vocal cord paralysis is more common than bilateral paralysis. Although rare, both types can affect individuals of any age.

Severity of Vocal Cord Paralysis

The severity of unilateral vocal cord paralysis varies from mild to severe. Mild cases may cause speech challenges, while severe cases may lead to shortness of breath during speech or difficulties in eating and drinking. Bilateral vocal cord paralysis can hinder breathing and swallowing, potentially resulting in aspiration pneumonia.

Symptoms and Causes

Symptoms of vocal cord paralysis include a hoarse, weak, or breathy voice, changes in vocal pitch or volume, shortness of breath, noisy breathing, and difficulty swallowing. The sensation resulting from a paralyzed vocal cord may feel like fatigue, a choking sensation, or a persistent feeling of throat mucus.

Speaking with Vocal Cord Paralysis

Individuals with vocal cord paralysis can often still speak, but it may require more effort, with noticeable changes in voice quality and potential speech fatigue. Severe cases may lead to a complete loss of voice.

Causes of Vocal Cord Paralysis

Autoimmune diseases, infections, injuries, neurological diseases, exposure to toxins, surgeries, tumors, and idiopathic or post-viral cases can contribute to vocal cord paralysis.

Diagnosis and Tests

Healthcare providers, particularly otolaryngologists and laryngologists, diagnose vocal cord paralysis through inquiries about symptoms and medical history, along with imaging studies (MRI or CT scan), laryngoscopy, videostroboscopy, laryngeal electromyography (LEMG), and blood tests.

Management and Treatment

Treatment varies based on the paralysis severity. Mild cases may benefit from voice therapy, while more severe cases may necessitate surgery. Unilateral paralysis treatment options include vocal cord injection, laryngeal framework surgery, and nerve surgery. Bilateral paralysis may require a tracheostomy to address breathing difficulties.

Possibility of Repair

In some instances, vocal cords may self-repair over time. Voice therapy, vocal cord injections, or implants can strengthen the voice and improve swallowing and breathing. The extent of recovery varies, and healthcare providers can offer guidance on expected outcomes.

Prevention

Preventing vocal cord paralysis is not always feasible. Regular checkups and voice therapy may be recommended for those at risk, but proactive measures are limited.

Outlook and Prognosis

Many cases of vocal cord paralysis can improve over time, with treatments like voice therapy and filler injections alleviating symptoms. Permanent paralysis may be addressed with vocal cord implants. Prognosis depends on factors such as the affected vocal cords, paralysis severity, and chosen treatment.

Living With

Seek medical attention if signs of vocal cord paralysis, such as voice changes or breathing difficulties, arise. Early intervention, including noninvasive treatments like voice therapy, can prevent progression to surgery in some cases.

Originally published at https://alttib.com on December 30, 2023.