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Vocal cord paralysis

Abraham Eisenstein, M.D. ▼ | April 28, 2010
Vocal cord paralysis, the inability to move the muscles that control the vocal cords, may be a sign of a serious disease and it can be life-threatening.
Vocal cord paralysis
Vocal cord paralysisVocal cord paralysis, the inability to move the muscles that control the vocal cords, may be a sign of a serious disease and it can be life-threatening.

At the first sight vocal cord paralysis may look like a benign condition, something that happens after a good football game or party, and sometimes it can look like a common cold. In the beginning it affects speaking and that's the reason why some patients don't pay attention to it, thinking that's something normal that will pass quickly. Unfortunately, that type of paralysis also affects breathing and swallowing, which means that it is a very serious disorder.

Vocal cord paralysis affects one or both vocal cords and it can appear for several reasons: it can be a brain disorder, a brain tumour, stroke, multiple sclerosis, or nerve damage. Nerves in larynx can be damaged by benign and malignant tumour, physical injury, or infection. It is important to notice here that poisons can also damage nerves (arsenic, lead or mercury), so it can be a sign of serious conditions in patient's environment which can lead to other diseases.

If one vocal cord is paralyzed the voice is hoarse and breathy, and when both vocal cords are paralyzed the voice is more silent but unfortunately is sounds normal. It is very easy to distinguish common cold from paralysis: since the space between the cords is very narrow, the air has not enough space to flow, so even light exercise causes difficulty in breathing and high-pitched sound while breathing.

So, if your throat doesn't hurt, but simple walking on stairs changes you pitch, you may be sure that you have vocal cord paralysis. If it doesn't go away in a day, you should see your doctor.

The first thing your doctor will do is to find why your vocal cords are paralyzed. He will examine all air pathways, do magnetic resonance imaging or computed tomography of the head, neck, and chest. That will help him to choose a proper treatment.

If there are no other diseases, such as tumours, and just one vocal cord is paralyzed, the help is in surgery: the paralyzed vocal cord will be moved to other position for more normal speech. This is a relatively simple and fast procedure.

If both vocal cords are paralyzed, then you have a serious problem. In that case food and water can be inhaled in trachea and lungs and this is obviously life-threatening condition. In that case the surgeon may need to open trachea through the neck (this is call tracheostomy). In very serious cases that opening may be permanent. In other cases the surgeon will remove vocal cord to prevent improper flow of food and water and in that case the patient won't be able to speak again.

Fortunately, the laser can help in some cases. The surgeon may use the laser to remove just one part of one or both vocal cords to widen the airways, and the results are usually very good: the patient has no more problems, the tracheostomy is not needed, and the voice is almost normal.