Vocal fold paralysis is a condition in which a vocal fold does not move. Normally, there are two vocal folds, both of which move from an open to a closed position to vibrate and produce sound. In vocal cord paralysis one vocal fold does not move to the closed position. The vocal cords are left unable to come together to the closed position causing hoarseness, a weak cough and even difficulty swallowing.
Vocal fold paralysis is typically due to a problem with the recurrent laryngeal nerve, the nerve that controls motion of the vocal fold. The recurrent laryngeal nerve travels from the brain, through the neck, into the chest and back to the voice box. When the nerve to the vocal fold is affected, it leaves the vocal cord immobile and paralyzed.
Causes of vocal cord paralysis include:
Injury to the recurrent laryngeal nerve during surgery. This occurs during surgeries that take placed close to the recurrent laryngeal nerve in the brain, chest or neck.
PDA (patent ductus arteriosus) ligation
ACDF (anterior cervical disc fusion)
Pressure on the nerve from a mass in the neck or chest, such as a thyroid cancer, esophageal cancer, or lung cancer.
Swelling of the nerve for unknown reasons. This is also known as “idiopathic” vocal cord paralysis and occurs is responsible for paralysis approximately 30% of the time.
Vocal fold paralysis can cause symptoms including:
Difficulty while swallowing
Choking while swallowing
Sensation of “phlegm in the throat”
Frequent clearing of the throat
Sensation of feeling “out of breath”
The symptoms of vocal fold paralysis occur because the vocal folds are unable to meet in the midline. Sound production is weak and patients feel out of breath because they have a constant air escape from the lungs through the voice box.
The symptoms of vocal fold paralysis are not always obvious. Patients may experience varying degrees of hoarseness, from mild to severe.
To evaluate for the cause of a vocal fold paralysis, a CT or MRI is used to examine the entire course of the nerve, from the skull to the chest. Occasionally a thyroid cancer, lung cancer, or even aortic aneurysm is unexpectedly diagnosed during this study and found to be causing vocal fold paralysis.
In cases in which vocal fold paralysis is potentially reversible, such as a when idiopathic, or when the nerve is inflamed (but not cut) after surgery, paralysis may resolve up to one year after injury.
If the nerve is cut, or if a year has passed since injury and the vocal cord is not moving, permanent intervention is suggested.
The treatments of vocal fold paralysis move the paralyzed vocal fold to the midline. Treatments do not restore the mobility of the vocal fold.
A thyroplasty is a surgery in which the voice box is entered and an implant is used to push the vocal fold to the midline.
Laryngeal reinnervation is a surgery is which the recurrent laryngeal nerve is cut, and then connected to another nerve. This allows the vocal fold to strengthen, moving the vocal fold to the midline, improving symptoms.
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.
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Didn’t feel care for left the office feeling discouraged, dr didn’t seem interested in finding out why I’m having my symptoms. From his opinion I’m fine. When a doctor wants to really help they’ll try all test possible to find the problem, instead he said I need to see a pain specialist and I left.
I couldn’t ask for a better experience with a Doctor and staff. Dr. Verma put me at ease and walked me through the Vocal fold injection process. He made it an easy experience and he was always informative and willing to answer questions. I felt heard and never rushed.
Dr. Verma is awesome. He takes the time to answer any questions or concerns you may have without making you feel rushed. He’s very skilled at what he does, and his staff is very friendly. I highly recommend him!!
Dr. Verma was warm, kind, spent adequate time, seemed incredibly knowledgeable. Despite not knowing exactly what I'm experiencing, he was confident in a course of action. His staff was very nice as well.
All the Dr's, Nurse's & Staffs of the UCI are amazing!! They are very polite, loving, kind, and all around great Team!! Special thanks to Doctor Verma for all the work that you're done for my dad. Our family sincerely appreciate all of you very much!!
Dr. Verma and his staff were totally professional. I came in from Palm Springs and it truly was worth the ride. I have what’s called a ZINKER. He had to put a tube down my nose to examine me. I didn’t feel a thing.Forgot to mention I’m a big baby. All in all it was a very good experience. Thank you Dr. Verma