Bilateral vocal cord paralysis occurs when both vocal folds are unable to move. Bilateral vocal fold paralysis most commonly occurs because of a problem with the recurrent laryngeal nerve, which is the nerve which controls motion of the vocal folds . The recurrent laryngeal nerve travels upwards towards the larynx next to the trachea and esophagus and is responsible for these motions. When the nerves are normal and vocal folds are unable to move, there may be problem with the cricoarytenoid joint.
Patients with bilateral vocal fold immobility may complain of:
Shortness of breath
Normal voice and sometimes altered voice
Bilateral vocal fold immobility may be a result of many causes. Some of these include:
Surgery, including spine, esophagus, or thyroid surgery
Stroboscopic examination of the larynx
Treatment for bilateral fold paralysis is primarily aimed at enlarging the size of the airway to improve breathing. Most commonly the vocal folds remain fixed in a ‘near closed’ position, preventing the breathing in and out large amounts of air. Patients complain of shortness of breath with exertion, such as walking up stairs.
The challenge in treating patients with bilateral vocal fold immobility is the following. As the size of the airway is increased, a patient’s voice and ability to swallow worsen.
Bilateral vocal fold immobility can be a result of
Surgery, including spine, esophagus, or thyroid surgery
Treatments for bilateral vocal fold immobility include:
Tracheotomy – the narrowed area is bypassed with a tracheotomy tube. Patients are able to speak and swallow normally.
Cordotomy – Vocal fold cordotomy literally means to cut the vocal fold. Cutting the vocal fold increases the size of the airway, but also affects a patient’s voice. Occasionally only cutting the vocal fold provides an adequately sized airway. This surgery is done in the operating room through the mouth during direct laryngoscopy. A microscope is used to enlarge the view of the vocal folds and a laser is used to cut the vocal fold.
Arytenoidectomy – the arytenoid is the cartilage that is connected to the back half of the vocal fold. Removing a portion of this cartilage enlarges the airway. This is done in conjunction with a cordotomy, and is performed through the mouth using a laser.
Vocal fold lateralization – In this procedure the vocal fold is positioned to the side, or laterally, to enlarge the size of the airway. This is done with a stitch passed from the skin to the inside of the larynx and back out. This procedure is temporary.
Throatdisorder.com is an online resource for patients and physicians to learn more about common voice, swallowing, breathing and throat disorders. Throat complaints, from cough to cancer, are a common reason for patients to seek medical treatment. This website developed as a result of Dr. Sunil Verma's passions: that of education, patient care, and interest in technology.
Irvine Location 250 E. Yale Loop, Suite 200 Irvine, CA 92604
Not sure why all those good reviews were posted. They were very misleading and I personally can say that my experience was absolutely negative. I was seen by Dr. Verma on 01/30/20 and there was no one in the waiting room which can be sometimes a bad sign. A nurse spray some lidocaine plus some other component inside my nostrils and told me that a test will be conducted later on by Dr. Verma. I saw Dr. Verma after a few minutes and I told him everything about my chronic cough and the throat infection that I went through a month ago...He did not conducted the test which i received the lidocaine for, he looked at inside my nostrils, my ears, my throat and his response was that I had enough medication, even though I am not taking anything for the last 10 days. He said to come back if the cough continues beyond February. Last night, my ear was popping and felt inflamed with a little bit of pain which usually happens due to my constant coughing; so, I decided to call the Dr.'s office. I was told that he doesn't work on Fridays and that his nurse will helped me out. His nurse which I did not get her name said that Dr. Verma is just a throat specialist that if I have ear problems I should see an ear specialist. I wonder why then he is called an ENT, didn't he go to school to be trained in ear, nose and throat conditions? My ear problem wasn not severed, just needed some basic ear drops for my inflation. The nurse insisted that he only sees throats! I told her that he looked at my ears and nostrils yesterday and that he probably know the basic issues related to ears...besides these three body parts are very well connected. My take is that this practice only cares about taking your money and that the nurse needs to retake her continuing education and get a broader education on the ENT field and about the Dr. what can I tell you his 5 minutes and were easily cover with my 50 dollars copay, I am sure my insurance will double or triple that charge. I hope I don't get charge for the unnecessary lidocaine spray since no test was conducted. I will never go back to this practice and my advice to you who is reading this honest review is that you look somewhere else too.
My wife had an office visit to Dr. Verma recently. The visit took no more than 15 minutes. During the visit, Dr. Verma performed Laryngoscopy on my wife. The procedure took no more than 2 minutes. Today I received the bill. Dr. Verma charged us more than $700 for the office visit, and more than $800 for the Laryngoscopy. With the insurance adjustments, we still have to pay about $1,300. I find it very hard to justify this price for the medical service provided.BTW, Dr. Verma did not cure my wife at all.
I made an appointment to see Dr. Verma for a second opinion and I am happy I did. His office staff is friendly and efficient. He is very knowledgeable and very personable. He carefully listened to my situation before the exam and clearly explained my condition and treatment. I feel very comfortable being treated by him and highly recommend him.
NOTE : The information presented on this site is for educational purposes only, and is not intended to replace consultation with a qualified physician. It may not be appropriate to your individual case, and should not be used in making treatment decisions, especially with regard to medication. Considerable effort is made to ensure that the information on this site is accurate, but medicine is a changing field, and this website is not responsible for errors or omissions. Use of this website acknowledges the above.