Vocal Cord Paralysis

Paralysis of the vocal cord is defined as a vocal fold that is not able to move. In most cases, the vocal cords vibrate and make sounds by moving from an open position to a closed position. When one of the folds is not able to move into the closed position, this is vocal cord paralysis. The condition prevents the vocal cords from moving toward each other and causes symptoms such as a hoarse voice and difficulty with swallowing.

Causes of Vocal Cord Paralysis

In most people with vocal cord paralysis, the condition results from a recurrent problem with the laryngeal nerve. This nerve controls the vocal cord’s movement. It travels from your brain and through the neck and chest before it enters the back of the voice box. Some other common causes of vocal cord paralysis include pressure on the laryngeal nerve due to thyroid cancer, lung cancer, or cancer of the esophagus. An injury to the nerve during a surgery in the brain, chest, neck, heart, thyroid, or lung can also damage the nerve. Medical procedures such as patent ducturs arteriosis ligation, anterior fusion of cervical vertebrae, and carotid endarterectomy can also trigger problems with the nerve. Swelling of the laryngeal nerve is responsible for about 30 percent of cases of vocal cord paralysis.

Vocal Cord Paralysis UCI Head Neck 1 - Vocal Cord Paralysis
Vocal Cord Paralysis UCI Head Neck 2 - Vocal Cord Paralysis

Symptoms of Vocal Cord Paralysis

A person can experience mild to severe symptoms of vocal cord paralysis. In some cases, the symptoms are not obvious as to what is going on with the vocal cords. The symptoms happen because of the inability of the vocal folds to meet. The constant escape of air through the lungs and voice box make it challenging to breathe and make sounds with your voice. The most common symptoms of vocal cord paralysis are coughing, a weak or breathy voice, hoarseness, and feeling out of breath. You might also notice a need to clear your throat frequently. Trouble swallowing or choking while swallowing is also common.

Diagnosis and Treatment

Stroboscopy and laryngoscopy procedures are used to diagnose paralysis of the vocal cord. Some patients might need a CT or MRI scan so the doctor can get a better view of the laryngeal nerve. When the nerve is only inflamed and not damage, the symptoms might clear up within a year with no treatment necessary. If the nerve was cut during surgery or the symptoms do not get better after one year, treatment is needed.

One method of treating the paralysis is to inject the vocal cord with a filling agent. This bulks the paralyzed area and moves it to the middle of the cord. A thyroplasty involves placing in implant into the voice box so that the vocal fold is correctly positioned. Another surgical method involves re-innervation of the laryngeal nerve. The nerve is cut and connected to a different nerve to strengthen the nerve. This process also shifts the laryngeal nerve into the proper position.

Vocal Cord Paralysis UCI Head Neck 3 - Vocal Cord Paralysis