Description

Vocal cord paralysis is a condition that causes the loss of control of the muscles that control your voice. This occurs when the nerve impulses to your voice box, also called the voice box (larynx) are disrupted. This results in paralysis of the vocal cord muscles.

Paralysis of the vocal cords can make it difficult to talk and breathe. The vocal cords, also called vocal folds, do more than just produce sound. It also protects the respiratory tract. To avoid that food, drink, and saliva, even entering the windpipe (trachea) and cause a person to drown.

Possible causes of paralysis of the vocal cords, which include nerve damage during the surgery, viral infections, and certain types of cancer. Treatment for vocal cord paralysis usually involves surgery, and sometimes the voice therapy.

Symptoms

Paralysis of the vocal cords, which usually consists of the loss of control of only one vocal cord. Paralysis of both vocal cords is a rare but serious illness. This can make it difficult to talk and can cause problems with breathing and swallowing.

The vocal cords are two bands of flexible muscle tissue that sit at the entrance to the trachea, also known as the trachea. When speaking, the bands come together and vibrate to make the sound. The rest of the time, the vocal cords are relaxed in an open position to be able to breathe.

The symptoms of paralysis of the vocal cords may include:

  • A sound of the quality of the voice.
  • The hoarseness.
  • Noisy breathing.
  • Shortness of breath.
  • The loss of vocal pitch.
  • Choking or coughing while swallowing food, drink or saliva.
  • The necessity of taking in several breaths of air as he speaks.
  • Inability to speak in a loud voice.
  • The loss of the gag reflex.
  • Cough unproductive.
  • Frequent throat clearing.

When to see a doctor

Contact your health care professional if you have a hoarse voice that can not be explained and that lasts more than 2 to 4 weeks. Also consult with your health care professional if you notice any changes in the voice or discomfort.

Causes

Vocal cord paralysis occurs when the nerve impulses to your voice box, known as the voice box (larynx) are disrupted. This makes the muscle is paralyzed. Often the exact cause of the paralysis of the vocal cords is not known. But some of the causes may include:

  • The injury to the vocal cords during surgery. The surgery in or near the neck or upper chest may result in damage to the nerves that serve the voice box. The surgeries that carry a risk of damage include surgery to the thyroid or parathyroid glands, esophagus, neck, and chest.
  • The neck or chest injury. Trauma to the neck or in the chest can cause damage to the nerves that serve the vocal cords or voice box itself.
  • Stroke. A stroke interrupts the flow of blood in the brain and can cause damage to the part of the brain that sends messages to the voice box.
  • Tumors. Tumors, both cancerous and non-cancerous, they can grow in or around muscles, cartilage or the nerves that control the function of the voice box. This can cause paralysis of the vocal cords.
  • Infections. Some infections, such as Lyme disease, Epstein-Barr virus and herpes, can cause inflammation and directly damage the nerves in your voice box. There is some evidence that infection with COVID-19 can cause paralysis of the vocal cords.
  • Neurological conditions. Certain neurological conditions, such as multiple sclerosis or Parkinson's disease, can lead to paralysis of the vocal cords.

Risk factors

The risk factors of vocal cord paralysis include:

  • To have the throat or chest surgery. People in need of surgery of the thyroid gland, throat, or upper part of the chest have a higher risk of damage to the nerves of the vocal cords. Sometimes, the breathing tubes are used in surgery or to help people breathe when they are having serious breathing problems can damage the vocal cords of the nerves.
  • Have a neurological condition. People with certain neurological conditions such as Parkinson's disease or multiple sclerosis — are more likely to develop vocal cord weakness or paralysis.

Complications

The respiratory problems associated with paralysis of the vocal cords can be so mild that you just have a hoarse voice. Or may be so severe that they are in danger of life.

Paralysis of the vocal cords keeps the opening of the airway from fully opening or closing. This can cause that someone is choking or inhaling food or liquid, known as aspiration. The aspiration that leads to a severe pneumonia is a rare but serious and requires immediate medical attention.

Diagnosis

For the diagnosis of paralysis of the vocal cords, your health care professional will ask about your symptoms and lifestyle. Your health care professional to listen to his voice and asks how long you've had voice changes. You may also need the following tests:

  • The laringoscopia.Su healthcare provider looks at your vocal cords using a mirror or a thin, flexible tube known as a laryngoscope or endoscope, or both. You can also have a test called videostrobolaryngoscopy. It uses a special instrument that contains a small camera at the tip or a larger chamber connected with the field of view of the piece. These special high-magnification endoscopes allow your healthcare provider to view their vocal cords directly or on a video monitor. The tests reveal the movement and position of the vocal cords. This can tell your health care professional if one or both vocal cords are affected.
  • Electromyography laryngeal.This test measures electrical currents in the voice box muscles. To do this, small needles are inserted into the vocal cord muscles through the skin of the neck. This test is not used to guide treatment, but it can give you a estimate regarding the way in which it can recover. This test is most useful when it is between six weeks and six months after your symptoms start.
  • Blood tests and exams. Several diseases can cause lesions in the nerves. You may need additional tests to determine the cause of the paralysis. The tests may include blood tests, X-rays, magnetic resonance imaging or computed tomography.

The laryngoscopy. Your healthcare provider looks at your vocal cords using a mirror or a thin, flexible tube known as a laryngoscope or endoscope, or both. You can also have a test called videostrobolaryngoscopy. It uses a special instrument that contains a small camera at the tip or a larger chamber connected with the field of view of the piece.

These special high-magnification endoscopes allow your healthcare provider to view their vocal cords directly or on a video monitor. The tests reveal the movement and position of the vocal cords. This can tell your health care professional if one or both vocal cords are affected.

Electromyography laryngeal. This test measures electrical currents in the voice box muscles. To do this, small needles are inserted into the vocal cord muscles through the skin of the neck.

This test is not used to guide treatment, but it can give you a estimate regarding the way in which it can recover. This test is most useful when it is between six weeks and six months after your symptoms start.

Treatment

Treatment of vocal cord paralysis depends on the cause, the severity of symptoms and when the symptoms began. The treatment may include voice therapy, bulk injections, surgery, or a combination of treatments.

In some cases, you can improve without surgical treatment. For this reason, your health care team may be delayed permanent surgery for at least a year from the beginning of his paralysis of the vocal cords.

However, the surgical treatment with several massive injections are often done within the first three months of loss of voice.

During the waiting period for surgery, you can receive voice therapy to help maintain the use of the voice improperly while the nerves heal.

Voice therapy

Voice therapy sessions involve exercises or other activities to strengthen the vocal cords, and help to improve the control of breathing during speech. Voice therapy may also prevent tension in the muscles around the paralyzed vocal cord or rope, and protect your airway during swallowing. Voice therapy may be the only treatment needed if the paralysis occurs in an area that does not require additional bulk or repositioning.

Surgery

If the paralysis of the vocal cords symptoms do not fully recover on their own, you may need surgery to improve their ability to speak and swallow.

Surgical options include:

  • Bulk of the injection. The paralysis of the nerve to your vocal cord will probably leave the vocal cord muscle thin and weak. A doctor who specializes in disorders of the larynx, known as an otolaryngologist, you can add volume to the paralyzed vocal cord. This is done by the injection of the vocal cord with a substance such as body fat, collagen or other approved filler substance. This is in addition to bulk brings the affected vocal cord closer to the center of the voice box. Then, the operation of the vocal cords can make a closer contact with the sick of the palsy of the marrow to speak, swallow or cough.
  • Structural implants. This procedure is based on the use of an implant in the larynx to change the position of the vocal cords. The procedure is also known as thyroplasty, medialization laryngoplasty or laryngeal framework surgery. Rarely, people who have this surgery you may need a second surgery to replace the implant.
  • The vocal cords of repositioning. In this procedure, a surgeon moves a window of its own tissue from the outer part of the voice box inside, pushing the paralyzed vocal cord toward the center of the voice box. This allows the operation of the vocal cords to the best vibe against the paralyzed vocal cord.
  • Replacement of the damaged nerve, known as the reinnervation. In this surgery, a healthy nerve is moved from a different area of the neck to replace the damaged vocal cords. It can take 6 to 9 months before your voice gets better. This surgery is sometimes combined with a mass injection.
  • The tracheostomy.If both vocal cords are paralyzed and placed in close collaboration, the air flow will be decreased. This causes a lot of difficulty breathing and require a surgery called a tracheotomy. An incision is made in the front part of the neck, to create an opening in the trachea, also known as the trachea. A breathing tube is inserted, allowing the entry of air to the derivation of the vocal cords.

The tracheostomy. If both vocal cords are paralyzed and placed in close collaboration, the air flow will be decreased. This causes a lot of difficulty breathing and require a surgery called a tracheotomy.

An incision is made in the front part of the neck, to create an opening in the trachea, also known as the trachea. A breathing tube is inserted, allowing the entry of air to the derivation of the vocal cords.

Emerging treatments

The pairing of the vocal cords to any other source of electrical stimulation can restore the opening and closing of the vocal cords that can not be moved. Other sources of electrical stimulation can be a nerve from another part of the body or of a device similar to a cardiac pacemaker. Researchers continue to study this and other options.

Coping and support

Paralysis of the vocal cords can be frustrating and affect your daily life. It can be difficult to communicate with other people. A speech therapist can help you develop the skills you need to communicate.

Even if you are not able to retrieve the voice that you once had, the voice therapy can help you learn the effective ways of to make for him. In addition, a speech-language pathologist can teach you how to use your voice, without causing more damage to the vocal cords.

Preparing for your appointment

It is likely that you first consult your health care professional about the paralysis of the vocal cords. But if both vocal cords are paralyzed, it is likely that the first to be seen in a hospital emergency department.

After the initial evaluation, it is likely that you will have to be referred to a doctor who specializes in ear, nose and throat conditions. You may also be referred to a speech-language pathologist for voice evaluation and therapy.

It is useful to get well prepared for your appointment. Here's some information to help you prepare and what to expect.

What you can do

  • Write down any symptoms you're experiencing, including any that do not seem to be related to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent illnesses or life changes.
  • Make a list of all medications, vitamins or supplements that you are taking, including the dosage of each one.
  • Ask a family member or friend to come with you, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who is with you may remember something that you missed or forgot.
  • Write questions to ask their health care team.

Your time with your health care professional may be limited. Prepare a list of questions can help you make the most of their time together. For paralysis of the vocal cords, some basic questions to ask include:

  • What is the most likely cause of my paralysis of the vocal cords?
  • What kinds of tests do I need? Do these tests require any special preparation?
  • Is this condition temporary, or will you be my vocal cords always be paralyzed?
  • What treatments are available, and which do you recommend?
  • What types of side effects can I expect from treatment?
  • There are alternatives to the treatment that you are suggesting?
  • Are there any restrictions on the use of my voice after the treatment? If so, for how long?
  • I'm going to be able to speak or sing after the treatment?
  • Are there brochures or other printed material that I can take my house?

In addition to the questions that you've prepared to ask, please do not hesitate to ask any additional questions that occur during your appointment.

What to expect from your doctor

Your healthcare provider is likely to ask a series of questions, such as:

  • When did the symptoms begin?
  • Do any special events or circumstances that occur before or at the same time that their symptoms developed?
  • Has received any treatment yet?
  • The symptoms been continuous or come and go?
  • How are the symptoms that affect your lifestyle?
  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Do you have any other medical condition?
Symptoms and treatment of paralysis of the Vocal cords