What Is Vocal Cord Paralysis? What Does Limited Vocal Cord Movement Mean?
Vocal cord paralysis (also called vocal fold paralysis) is a term used to describe the restriction of vocal cord movement resulting from dysfunction of the nerve that should send signals to the muscles that make up the vocal cord tissue.
How Do the Vocal Cords Work in Healthy Individuals?
The vocal cords are located just above the trachea. Every person has two vocal cords. These two vocal cords are joined at one end in a V shape, while the other end is free. Normal vocal cords open during breathing and close completely during sound production or swallowing.
What Is Unilateral or Bilateral Vocal Cord Paralysis?
Paralysis of the two vocal cords presents as unilateral or bilateral, depending on the number of vocal cords affected.
What Are the Causes of Vocal Cord Paralysis?
The most common cause of unilateral vocal cord paralysis is surgical interventions performed in the head, neck, or chest cavity. During treatment of the relevant condition, the vocal cord nerve may be inadvertently damaged. In some cases, nerve damage becomes unavoidable in order to treat the disease. Common examples include thyroid (goitre) surgeries, cervical vertebra surgeries, heart and major vessel surgeries, and brain surgeries. The nerves supplying the vocal cords are very delicate, and even careful surgeries can often lead to an unavoidable loss of function.
The second most common reason for unilateral vocal cord paralysis is inflammatory conditions that lead to issues in the nerve functioning. This situation is most commonly seen after viral infections and can be temporary in some cases, meaning the nerve may start to function again after a while, and the paralysis resolves.
The third most frequent condition preventing the functioning of the unilateral vocal cord is tumours that exert pressure on the nerve. The relevant nerve and its branches start from the brain, pass through the neck, enter the thoracic cavity, and return to the neck to supply the vocal cords. Benign and malignant tumours that can develop along this long pathway may disrupt the nerve's function, preventing it from working. This situation may also result in vocal cord paralysis. The most common tumours that lead to vocal cord paralysis are those found in the lungs.
There are many other factors that can lead to unilateral vocal cord paralysis, including drug-related toxicity, neurological diseases, and brain haemorrhages.
What Are the Symptoms of Vocal Cord Paralysis? What Complaints Does Vocal Cord Paralysis Cause?
Individuals with unilateral vocal cord paralysis often complain of reduced voice quality. Hoarseness, weak voice production, a breathy voice as if there is a leakage while speaking, quick fatigue while talking for a while, insufficient loudness, and inability to produce the desired pitch are some of the possible voice problems. In some individuals, problems such as aspiration of liquid foods into the airway due to incomplete closure of the vocal cords — for example, frequent coughing while drinking water and a feeling of choking — may also be observed.
The main issues for individuals with bilateral vocal cord paralysis are inability to breathe comfortably, respiratory distress, and noisy and uncomfortable breathing during sleep. For more detailed information, you can click here to read our relevant page.
How Is Vocal Cord Paralysis Diagnosed? How Is It Understood That There Is Vocal Cord Paralysis?
The diagnosis of vocal cord paralysis can be made in an outpatient setting using appropriate imaging modalities such as videolaryngostroboscopy, flexible fibreoptic laryngoscopy and chip-tip high-resolution imaging. If necessary, acoustic analysis can be performed to determine how much the voice is affected by the condition.
In addition, a complete ear, nose, throat and head and neck examination should be performed to determine the cause of vocal cord paralysis, and if necessary, appropriate radiological examination methods (such as computed tomography and magnetic resonance imaging) and laboratory tests should be used to reveal the possible cause.
Which Methods Can Be Used in the Treatment of Individuals with Vocal Cord Paralysis? Can Vocal Cord Filling Be Applied?
The main methods used to treat voice problems associated with unilateral vocal cord paralysis include voice therapy, injection laryngoplasty (filling of the vocal cords, vocal cord filling, closed vocal cord surgery) and thyroplasty (open vocal cord surgery). Which of these methods is used, and its timing, may vary depending on the patient's clinical condition, current voice, and level of aspiration (fluid aspiration into the throat). After vocal cord paralysis occurs, the best results can be achieved if the correct procedures are applied as early as possible.
