Vocal Cord Paralysis

There are two types of vocal cord paralysis which are:

• Unilateral vocal cord paralysis: This type affects one cord and paralyses it. An individual suffering from this type might have trouble speaking or swallowing. Breathing problems aren’t experienced in this type.
• Bilateral vocal cord paralysis: In this type, both the cords are paralyzed as it causes a dangerously narrow airway. People with this type experience breathing problems and it can be life-threatening if not treated on time.

Vocal cord paralysis symptoms differ by the cause and whether one or both the vocal cords are affected. Have a look at the symptoms:

• Swallowing problems
• Incapability to raise voice in volume
•  Changes in voice sound
• Choking while eating or drinking
• Difficulty breathing
•  Loss of speaking ability completely
• Shortness of breath

If any of these symptoms are experienced, it is important to consult an ENT specialist for an evaluation.

There are various conditions causing damage to the nerves responsible for controlling the vocal cords functioning. These conditions are:

• Infections: There are multiple infections such as Lyme disease, the Epstein- Barr virus, COVID- 19, and herpes that causes inflammation and damage to the nerves controlling the vocal cord movement.
• Injury: The nerve damage is also caused by trauma to the chest, head, and neck.
• Autoimmune disease: This is a disease which interrupts the way nerves communicate with muscles like myasthenia gravis (MG) causing vocal cord paralysis.
• Neurological diseases: Conditions like stroke, Parkinson’s disease, and multiple sclerosis cause nerve damage and deterioration. It affects the nerve controlling and the movement of the vocal cords.
• Poisonous substances: Toxins like arsenic, mercury, and lead cause damage to the nerve tissue affecting vocal cords.
• Surgery: Surgeries related to head and neck such as parathyroid surgery, heart surgery, cervical spine surgery, thyroidectomy or thyroid gland removal cause complications like nerve damage. The use of a breathing tube during surgery can lead to nerve damage in the voice box sometimes.

Clinical professionals in ear, nose, and throat (ENT) conditions are known as otolaryngologists and providers’ experts in throat and voice box are laryngologists. They will ask about the symptoms and clinical history of an individual. Here are the tests that a doctor might order for vocal cord paralysis diagnosis:

• Imaging tests: Computerised tomography or CT scan and magnetic resource imaging (MRI) tests are recommended as they are useful in showing the detailed brain, vocal cords, voice box, chest, thyroid gland, and throat images. It might also include an X-ray, chest or oesophagus test.
• Laryngoscopy: It is ordered as this assists the doctor to view the voice box and vocal cords directly. The doctor will use a long device, and thin tube laryngoscope into the nose to perform a throat examination. It is a flexible tube which captures voice box and vocal cords images.
• Videostroboscopy: This test allows the doctor to analyse how the vocal cords are vibrating and how much nearer they have come while talking. This procedure is like a laryngoscopy. With the use of a camera, the doctor can view how the vocal cords move and make sounds.
• Laryngeal electromyography: This test helps to measure how nerves are controlling the muscles in the voice box. The doctor can initiate evaluating and recording the muscle's electrical impulses.
• Blood tests: The doctor might order blood tests to confirm vocal cord paralysis and to understand if the condition is related to an autoimmune illness or an infection.

One must consider the vocal cord paralysis treatment as soon as the symptoms are observed. No at-home treatment is available for this condition so one must get in touch with the doctor immediately when symptoms are observed. The treatment options for vocal cord paralysis are:

Voice therapy

Vocal cord paralysis usually goes away on its own within months or years. If the condition is not resolving by itself, then the doctor will order voice therapy. It helps in restoring the nerve communication between the larynx and brain before moving forward with the surgery option. The purpose of this therapy is to improve the vocal cords functioning through repetitive exercises. With simple exercises, one can retain their vocal cords easily.

Surgery

If voice therapy is not helping, then the doctor will suggest surgery. In case, both the vocal cords are paralysed then the doctor will ask to get the surgery done straightway.

Voice cord injection

It is a procedure which involves the use of injectable material so that the vocal cord is bulkier and is smooth to move. It is performed by putting a laryngoscope into the throat and takes only a few minutes for filling the vocal fold evenly.

Phonosurgery

This surgery is performed if one vocal cord is paralyzed. This procedure changes the vocal cords' shape and location. With this surgery, the cord is moved towards the one having nerve function. It allows an individual to produce the sound through their voice box, swallow, and breathe easily.

Tracheostomy

If both the vocal cords are paralyzed, then the doctor will perform a tracheotomy. This surgery will give direct access to the patient’s trachea (windpipe) so that an opening is created in the neck. The doctor will use a tube for breathing and clearing secretions from the windpipe. The surgery is performed only if paralyzed vocal cords cause issues like breathing, coughing, swallowing, and putting an individual in danger of suffocation. The tracheostomy tube can be permanent in some cases.

Rukmani Birla Hospital, Jaipur is among the well-known multispecialty hospitals across the city with cutting-edge medical equipment and outstanding infrastructure to offer wide-ranging care to patients. Our team of highly experienced doctors and surgeons offer complete medical care and post-operative tips for a smooth and fast recovery.

You can refer to our expert neuro doctor if you observe vocal cord paralysis symptoms. Here is why you must choose us:

• Up-to-date medical technology
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