Vocal fold paralysis

Two elastic bands of muscle tissues located in the larynx or voice box directly above the trachea or windpipe are called vocal folds or vocal cords. Vocal fold paralysis is a condition when the vocal folds do not open or close properly. The condition may affect either both the vocal folds or a single cord. Paralysis of a single vocal cord is common but that of both is rare and can be life threatening.

Symptoms of Vocal Fold Paralysis

The primary symptom of vocal fold paralysis is hoarseness of voice. There are certain other symptoms such as:

  • hoarseness or complete loss of speaking ability
  • difficulty swallowing
  • breathing difficulty
  • inability to raise your voice in volume
  • changes in the sound of your voice
  • frequent choking while eating or drinking
  • noisy breathing

The symptoms however, vary depending upon the cause and whether one or both of the vocal cords are affected.

Causes of Vocal Fold Paralysis

Vocal fold paralysis is caused by injuries upon head, neck or chest or some other serious ailments. The causes of Vocal Fold paralysis include:

  • injury to chest or neck
  • stroke
  • Lung and thyroid cancer
  • inflammation or scarring of the vocal cord joints due to strain or infection
  • neurological conditions, such as MS, Parkinson’s disease, or myasthenia gravis
  • benign tumours of the skull base, neck, or chest
  • infection such as: Lyme disease

But in many cases, the cause remains unknown.

Diagnosis of Vocal Fold Paralysis

If you experience hoarseness of voice or difficulty in breathing and swallowing, you must consult an Otorhinolaryngologist or ENT specialist. Listening to your symptoms and history, the doctor will start the diagnostic procedure. Endoscopy is the most common diagnostic procedure to confirm vocal fold paralysis. With the help of an Endoscope, a tube with a light at the end, the doctor looks directly into the throat at the vocal folds. Some doctors also use laryngeal electromyography, a procedure that measures the electrical impulses of the nerves in the larynx. This enables in better understanding of the areas of paralysis.

Treatment for Vocal Fold Paralysis

Treatment for vocal fold paralysis includes voice therapy and surgery. Initially, the doctor suggests for voice therapy and refers you to a speech-language therapy pathologist. Voice therapy involves exercises to strengthen the vocal folds or improve breath control while speaking. Your therapist will guide you how to use your voice differently by speaking more slowly or opening your mouth wider when you speak. Through simple repetitive exercises during voice therapy, the function of your vocal cord can be improved.

Surgical procedures include:

  • Vocal cord injection
  • Phonosurgery
  • Tracheotomy

Vocal Cord Injection: Vocal cord injection is pushed through the skin that covers the larynx to make your vocal cord bulkier and easier to move. The injection is pushed through a laryngoscope placed in the throat.

Phonosurgery: in case of a single vocal fold paralysis, Phonosurgery is done. With the help of Phonosurgery paralyzed vocal cord is moved towards the other vocal fold that is still functioning. This helps in producing sound through voice box, and swallowing and breathing more easily.

Tracheotomy: When both the vocal folds are paralysed, tracheotomy is done to help in breathing. During tracheotomy, a breathing tube is inserted through an opening, called a stoma in the front part of the neck, into the trachea. Now breathing is possible through the tube instead of the nose and mouth.

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