Bilateral Vocal Fold Paralysis

Vocal fold is a term interchanged with vocal cord. Vocal cords housed in the larynx or voice box produce the sound of voice by vibration. Many rare conditions exist that can affect voice quality due to issues with the vocal cord’s muscle movement. Bilateral vocal fold paralysis, a serious medical condition, results due to the lack of movement of either vocal cord.

Associated Symptoms of Vocal Fold Issues

Since vocal cords are unable to move with bilateral vocal fold paralysis, issues with breathing and eating often present due to constriction of the airway. Shortness of breath may develop due to the inadequate passing of air through the vocal folds. Those affected by this condition may need to make much more effort when inhaling or exhaling. Noisy breathing may result, referred to as stridor. The quality of one’s voice may become affected by the narrowing of the airway, resulting in a weakened or breathy voice. Additionally, eating may be a difficult task for those affected and may result in the aspiration of food or choking. This is due to the attempt of those who suffer to get an adequate breath through their limited airway while eating.

Bilateral Vocal Fold Paralysis 1 UCI Head Neck 1 - Bilateral Vocal Fold Paralysis
Bilateral Vocal Fold Paralysis 2 UCI Head Neck - Bilateral Vocal Fold Paralysis

Diagnosing Hypercalcemia

The diagnosis of hypercalcemia is complicated by the fact that the symptoms, when present, are often vague and generalized. The most effective way to diagnose the condition is with blood tests to determine if high levels of parathyroid hormone and calcium are present in the blood. Another indication of hypercalcemia is a low level of calcium excretion, which can be detected through a urine test. These tests can also be useful in identifying causes of hypercalcemia unrelated to parathyroid function and prevent unnecessary surgery. Various imaging tests of the bones and other tissues may be used to rule out cancer as the underlying cause of the hypercalcemia.

Treating Hypercalcemia

If the level of calcium in the blood is only mildly elevated, a wait-and-see approach along with dietary adjustments may be all that is necessary. If calcium levels remain elevated or increase, medications may be prescribed to manage parathyroid activity.

Short-term use of steroids may be used to treat hypercalcemia resulting from high levels of vitamin D. Diuretics and IV fluids may be required if calcium levels become dangerously high.

Diagnosing Issues of Vocal Nerves

Ear, nose and throat (ENT) specialists evaluating these symptoms are likely to recommend an MRI or CT scan. These imaging tests can rule out a potential mass or tumor in the head or neck area, which may be causing symptoms. The detection of either would prompt the treatment of these underlying issues. It is possible that after treatment, paralysis of the vocal folds can resolve itself. In cases where the cause for nerve constriction is unknown, vocal fold treatment may be necessary.

Treating Bilateral Vocal Fold Paralysis

Preventing patients from having complications due to breathing and airway issues is important. Thus, in effort to enlarge the airway, treatment using a small portion of one or both vocal folds may occur. This treatment option has the potential to further affect the quality of one’s voice. If the treatment goal is to avoid worsening issues with speaking and voice, a different approach may be necessary. This involves treatment using a portion of the arytenoid cartilage, located at the back of the vocal cords.

Bilateral Vocal Fold Paralysis 3 UCI Head Neck - Bilateral Vocal Fold Paralysis