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The inability to move one or both vocal folds is defined as paralysis of the vocal cords, a condition that results in respiratory, swallowing, and speech disorders.
Vocal cord paralysis is caused by the interruption of nerve impulses in the larynx, making it difficult for its muscles to open or close. Since there is no movement, speech, swallowing and breathing are impaired.
Sometimes the root of this voice organ disorder is unknown; others, it is due to different diseases or conditions. A text published by the Spanish Society of Otorhinolaryngology and Cervical-Facial Pathology highlights that laryngeal paralyzes present with dysphonia, dyspnea-stridor and aspiration when swallowing.
If the 2 vocal folds are left ajar and fixed in a paramedial position, the condition is bilateral. When it is only a paralyzed rope or with minimal movements, it is a unilateral paralysis.
Symptoms of vocal cord paralysis
The vocal cords are at the beginning of the trachea. They come together and vibrate to produce sounds; the rest of the time they remain open to breathe without difficulty. The problem is if these cords become numb and narrow the airway.
At any age you can suffer paralysis of the vocal folds. Altogether and with greater or lesser intensity, the patient manifests the following symptoms.
- Hoarseness or breathy voice.
- Choking when swallowing, even saliva or liquids.
- Trouble raising your voice.
- Loss of gag reflex.
- Noisy breathing
- Need to breathe frequently in the middle of speech.
Causes and risk factors for vocal cord paralysis
Although some specialists agree that vocal cord paralysis is sometimes idiopathic, there are factors that put at risk. Here we present them to you.
Trauma to the neck or chest
Injuries to these parts of the body could affect the nerves connected to the larynx or the cords. It is an injury that affects indirectly.
Inflammation
Diseases such as arthritis inflame the joints and soft tissues. A publication of the rheumatology section of the General Hospital Yagüe Burgos exposes that rheumatoid nodules could lodge in the vocal cords, conditioning the prognosis of the patient.
Throat or chest surgeries
Operating the upper chest, throat or thyroid increases the risk of damage to the vocal cords, especially when breathing tubes are used. A journalistic report based on a scientific study of the Indian Journal of Critical Care Medicine warns sequelae in the larynx after extubation of at least 24 hours.
Neurological or autoimmune conditions
Pathologies such as multiple sclerosis, myasthenia gravis or Parkinson’s deteriorate the nerves. This increases the chances of string paralysis or string weakness.
Tumors
The tumors in the nerves, cartilage and muscles that surround the larynx, or properly in it, increase the possibilities of damaging the voice cords by pressing on your nerves.
Cancer
Lung or thyroid carcinoma also have an incidence in the affection of the vocal organ. In few cases, dysphonia is one of the first symptoms that warn about the oncological process.
Diagnosis of vocal cord paralysis
In the interrogation to determine the disease, the otolaryngologist investigates both the history and the use of medications, such as the vincristine and the phenytoin, since both are associated with cases of vocal cord paralysis.
Also, the specialist pays attention to the voice to check the timbre. With a laryngoscope, examine the strings. There are also other methods:
- Videostrobolaryngoscopy: uses an endoscope with a camera that provides the magnification necessary to appreciate both the position and movement of the vocal folds.
- Electromyography: This test measures electrical impulses in the muscles of the larynx. The method consists of inserting small needles through the skin of the neck. It is ideal for monitoring recovery.
- Imaging and blood study: It includes CT scans, MRIs, lung function studies, and blood tests, especially when the condition stems from another disease.
Treatments for vocal fold paralysis
In mild cases, the treatment is voice therapy with exercises that strengthen the vocal cords, work breathing and teach control of the muscles of the folds.
On the other hand, the operating room is the way when paralysis is severe. Depending on the patient’s condition, the procedural options would be repositioning of the cords, structure replacement surgery, or a tracheostomy if both cords are affected.
There is an alternative which is medialization laryngoplasty. This technique is based on insert a structural implant into the larynx. As for electrical stimulation, it is a resource used to restore the opening and closing of the strings.
Is it possible to prevent vocal paralysis?
This condition is hardly preventable. However, knowing that you are a person at risk for autoimmune diseases, surgical interventions or another of the characteristics detailed above, it is advisable to consult with your doctor as soon as you notice changes in your voice that persist for more than 2 weeks.
Although it is difficult to stop it, vocal fold paralysis is curable by complying with therapies and exercises.
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