Vocal Cord Paralysis is a condition affecting the larynx, also referred to as the voice box, wherein the nerve signals relayed to the laryngeal tissues are impeded. This results in loss of movement in the vocal cord muscles, eventually leading to paralysis.
The larynx, commonly called the voice box or glottis, is located between the pharynx i.e., throat on top and the trachea or windpipe below, serving as a channel for the unobstructed movement of air. Within the larynx, the vocal cords are a pair of flexible muscles situated at the beginning of the trachea. Also referred to as vocal folds, the vocal cords move towards one another while speaking to vibrate and produce sound waves. When not talking, the vocal cords remain in a relaxed position to allow the smooth flow of air into the system and enable easy breathing.
Moreover, the vocal cords safeguard the airways in the lungs, by averting the passage of food, drink, saliva into the windpipe/trachea and thus preventing instances of choking. Due to being involved in these key functions, when the vocal cords are damaged like in vocal cord paralysis, it not only impedes speech but also triggers breathing difficulty. The majority of cases of vocal cord paralysis only report paralysis of one vocal cord. The paralysis of both vocal cords occurs quite rarely but is a grave disorder that hampers the capabilities of breathing and swallowing.
Causes Of Vocal Cord Paralysis:
The major causes of vocal cord paralysis consist of:
- Damage to the vocal cord nerves while undergoing other surgical procedures in the neck and chest area, like surgery in the thyroid gland or oesophagus i.e. food pipe
- Tumours and cancers that develop in the muscles, nerves, cartilage regulating the activity of the voice box
- Neurological disorders such as Parkinson’s disease, multiple sclerosis
- Injuries and severe trauma in the neck and chest region, which maims the nerves in the vocal cords or voice box/larynx
- Infections from bacteria such as Lyme disease, viral illnesses like herpes, Epstein-Barr virus, which lead to inflammation in the vocal cord muscles and nerves
Some individuals with pre-existing issues and sicknesses are more prone to developing vocal cord paralysis. These include:
- Requiring a chest or throat surgery, which at times comprise inserting breathing tubes into the airways, that hamper the functioning of the vocal cords, larynx and surrounding nerves
- Suffering from a neurodegenerative illness for a long period, like Parkinson’s or multiple sclerosis, which eventually damages nerves across the system resulting in vocal cord paralysis
The characteristic signs of vocal cord paralysis comprise:
- Breathing heavily creating a lot of noise
- Inability to control the vocal pitch while talking or singing
- Gruffness and hoarse sounds in the voice
- Clearing the throat often
- Taking deep breaths frequently while speaking
- Challenges in conversing in a loud volume
- Loss of gag reflex in throat muscles that help prevent choking
- Coughing up food particles and saliva while eating with difficulty swallowing meals, like in dysphagia
However, when intense breathing trouble results from vocal cord paralysis, immediate medical care must be provided to fix the respiratory passages and restore normal lung function.
The doctor questions the patient about how long the symptoms have persisted and listens to the irregularities in their voice. Then a series of tests are conducted to identify the severity and cause of vocal cord paralysis, which encompass:
- Laryngoscopy: which is an invasive endoscopy procedure, where the doctor views the internal tissue structures of the larynx and vocal cords, which helps spot if one or both vocal cords are injured, as well as gauge the motion and exact location of the vocal cords
- Laryngeal Electromyography: that assesses the electrical signals in the vocal cord and voice box muscles, which determines the efficacy of treatment for vocal cord paralysis and indicates the extent to which the patient can recover vocal cord function
- Blood Tests And Imaging Scans: such as collecting blood samples, X-ray, MRI and CT scans are also performed to evaluate the exact cause of vocal cord paralysis
Treatment for vocal cord paralysis depends on the cause and severity of the condition in the patient.
In minor cases of vocal cord paralysis, voice therapy is given to the patient, which entails exercises and training to make the vocal cord muscles stronger, as well as enhance breath control while talking and avoid situations of choking while eating.
Nevertheless, if vocal cord paralysis is rather serious with considerable damage to the larynx, then surgery by means of bulk injections, structural implants, vocal cord repositioning, replacing the injured nerve or tracheotomy by placing breathing tubes in the trachea to permit the passage of air through vocal cords is performed. These procedures ensure recovery of vocal cord function to some extent, or enable normal breathing, swallowing in the patient.