Vocal Cord Paralysis: Symptoms, Causes, Treatment

What are the symptoms of vocal cord paralysis?

Vocal cord paralysis can cause a range of symptoms, including:

• Hoarseness: A raspy or strained voice due to one or both vocal cords not functioning properly.
• Weak Voice: Difficulty speaking loudly or projecting the voice.
• Breathiness: A breathy voice caused by air escaping through the vocal cords.
• Difficulty Swallowing: Problems with swallowing, which may lead to choking or coughing during meals.
• Increased Throat Clearing: Frequent throat clearing or coughing to clear the airway.
• Shortness of Breath: Difficulty breathing, especially when speaking or exercising.
• Voice Fatigue: Feeling tired or strained after speaking for a short period.
• Changes in Pitch: Difficulty reaching high or low pitches or experiencing a voice that is out of tune.

The symptoms can vary depending on whether one or both vocal cords are affected and the extent of the paralysis. If vocal cord paralysis is suspected, it’s important to consult an otolaryngologist for an accurate diagnosis and appropriate treatment plan.

What are the causes of vocal cord paralysis?

Vocal cord paralysis can be caused by a variety of factors, including:

• Nerve Damage: Injury to the recurrent laryngeal nerve or the vagus nerve, which control the vocal cords, due to surgery (especially neck or chest surgeries), trauma, or tumors.
• Neurological Disorders: Conditions like stroke, multiple sclerosis, Parkinson’s disease, or amyotrophic lateral sclerosis (ALS) can affect the nerves that control the vocal cords.
• Viral Infections: Certain viral infections can damage the nerves controlling the vocal cords.
• Thyroid Disorders: Thyroid surgery or thyroid cancer can affect the nerves near the vocal cords.
• Tumors: Tumors in the throat, neck, or chest can press on or invade the nerves responsible for vocal cord movement.
• Autoimmune Diseases: Conditions like rheumatoid arthritis or lupus can involve the vocal cords or their controlling nerves.
• Trauma: Direct injury to the neck or chest that affects the nerves or muscles controlling the vocal cords.
• Idiopathic: In some cases, the cause of vocal cord paralysis is unknown.

Diagnosis typically involves a thorough examination by an otolaryngologist, including imaging studies and possibly laryngoscopy to visualize the vocal cords.

What is the treatment for vocal cord paralysis?

Treatment for vocal cord paralysis depends on the severity of the condition and its underlying cause. Approaches include:

• Voice Therapy: Speech-language pathologists can work with patients to improve voice quality and use techniques to manage symptoms.
• Medications: If inflammation or an underlying condition like an autoimmune disease is contributing to the paralysis, medications such as steroids or other treatments may be used.
• Surgical Interventions:
• Thyroplasty: A surgical procedure where a small implant is placed to help improve vocal cord position and voice quality.
• Arytenoid Adduction: A procedure to move the paralyzed vocal cord toward the midline to improve voice production and airway protection.
• Injection Laryngoplasty: Injecting material (like collagen or fat) into the vocal cord to improve its position and function.
• Addressing Underlying Conditions: Treating the cause of the paralysis, such as managing a tumor or addressing thyroid issues, may improve or resolve the paralysis.
• Diet and Lifestyle Adjustments: In some cases, changes in diet and lifestyle can help manage symptoms and prevent complications.

The choice of treatment is tailored to the individual’s specific situation and needs, often involving a multidisciplinary team including otolaryngologists, speech-language pathologists, and other specialists.