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Vocal Cord Paralysis: Causes, Symptoms, Risk Factors, Diagnosis And Treatments

Vocal cord paralysis is a condition in which the nerves to one or both the vocal cords (unilateral or bilateral) gets disrupted or are unable to move. Vocal cords or vocal folds are a pair of tissues in the larynx that help us speak, swallow, breathe, cough or laugh. [1]

Vocal cord paralysis causes problems in our ability to breathe, speak and swallow. The condition is life-threatening and requires immediate medical attention. This is because, apart from producing sound, the vocal cord also helps close the windpipe while eating to prevent the entry of foods or liquid in the lungs. When vocal cords dysfunction, the risk of choking out to death increases due to the entry of food particles in the lungs. Know more about the condition.

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Causes Of Vocal Cord Paralysis

Voice cord paralysis is caused by damage or disruption to the larynx or voice box nerves that results in paralysis of the vocal muscles. Common causes include:

  • Lesions in the vocal cord nerves [2]
  • Trauma or injury to the nerves of the neck
  • Tumours around the voice box
  • Injury to the neck nerves due to surgery (such as thyroid surgery)
  • Inflammation of the larynx due to infections.
  • Neurological problems such as multiple sclerosis
  • Brain damage affecting the vocal cord muscles
  • Radiation therapy

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Symptoms Of Vocal Cord Paralysis

Vocal cords are two muscle folds located inside the larynx. When we speak, the air passes from lungs to these folds, causing them to vibrate and produce sound. The paralysis of vocal cord causes symptoms such as:

  • Hoarseness (abnormal voice)
  • Difficulties while swallowing food or coughing [3]
  • Shortness of breath
  • Pneumonia (mainly due to the entry of food and liquid in the lungs) [4]
  • Frequent throat clearing
  • Breathy voice
  • Reduction in speech volume
  • Choking which may cause death

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Risk Factors Of Vocal Cord Paralysis

  • Oesophagus, thyroid or chest surgeries [5]
  • Long-term intubation of people above 50.
  • Conditions that affect nerves such as Parkinson's disease and multiple sclerosis.

Complications Of Vocal Cord Paralysis

Vocal cord paralysis can cause serious pneumonia that results from infection when the food and liquid enter the lungs.

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Diagnosis Of Vocal Cord Paralysis

  • History and physical examination: Here, a medical expert asks questions about patient's history such as exposure to radiation or any preexisting conditions such as Lyme disease. Hoarseness or breathy voice is also analysed during physical examination.
  • Laryngoscopy: To look out for inflammation, infections or other problems in the larynx. The procedure gets a close view of the throat. [6]
  • Laryngeal electromyography: To record the electrical movement in the vocal cord muscles. This gives an idea to a doctor in how much time a person can recover.
  • Imaging tests: It includes a CT scan or X-ray to identify the cause of damage to the nerves.

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Treatment Of Vocal Cord Paralysis

The treatment of vocal cord paralysis depends on the severity of the condition.

  • Voice therapy: Before going for surgery, a medical expert first recommends voice therapy to treat the condition. It includes exercises to strengthen the vocal cord muscles, control breathing while speaking and avoiding swallowing difficulties. [7]
  • Surgery: If the symptoms do not improve even after a year of practising voice therapy, surgery is suggested. It includes tracheotomy, bulk injection, vocal cord correction, thyroplasty or reinnervation.

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Common FAQs

1. Can you recover from vocal cord paralysis?

Yes, a person can recover from vocal cord paralysis. Practising voice therapy (exercises) for around 6 months can help a lot in treating the condition. If not, surgical methods are the next step to treat vocal cord paralysis.

2. Is vocal cord paralysis permanent?

Vocal cord paralysis can be permanent if not treated at an early stage. It can also cause serious pneumonia or infection if the condition remains untreated for longer.

3. What does a paralyzed vocal cord feel like?

In vocal cord paralysis, a person is unable to speak loudly or properly. The voice will be hoarse, reduced in volume, noisy, breathy or painful. Also, you will experience frequent coughing due to problems while swallowing foods.

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