Vocal cord paralysis

DEFINITION

Vocal cord paralysis occurs when the nerve impulses to your voice box (larynx) are disrupted. This results in paralysis of the vocal cord muscles.

Vocal cord paralysis can affect your ability to speak and even breathe. That’s because your vocal cords, sometimes called vocal folds, do more than just produce sound. They also protect your airway by preventing food, drink and even your saliva from entering your windpipe (trachea) and causing you to choke.

There are a number of causes of vocal cord paralysis including nerve damage during surgery, viral infections and certain cancers. Treatment for vocal cord paralysis usually involves surgery.

CAUSES

In vocal cord paralysis, the nerve impulses to your voice box (larynx) are disrupted, resulting in paralysis of the muscle. Doctors often don’t know the cause of vocal cord paralysis. Known causes may include:

• Injury to the vocal cord during surgery. Surgery on or near your neck or upper chest can result in damage to the nerves that serve your voice box. Surgeries that carry a risk of damage include surgeries to the thyroid or parathyroid glands, esophagus, neck, and chest.
• Neck or chest injury. Trauma to your neck or chest may injure the nerves that serve your vocal cords or the voice box itself.
• Stroke. A stroke interrupts blood flow in your brain and may damage the part of your brain that sends messages to the voice box.
• Tumors. Tumors, both cancerous and noncancerous, can grow in or around the muscles, cartilage or nerves controlling the function of your voice box and can cause vocal cord paralysis.
• Viral infections. Some viral infections, such as Lyme disease, Epstein-Barr and herpes, can cause inflammation and damage directly to the nerves in the larynx.
• Neurological conditions. If you have certain neurological conditions, such as multiple sclerosis or Parkinson’s disease, you may experience vocal cord paralysis.

SYMPTOMS

Your vocal cords are two flexible bands of muscle tissue that sit at the entrance to the windpipe (trachea). When you speak, the bands come together and vibrate to make sound. The rest of the time, the vocal cords are relaxed in an open position, so you can breathe.

In most cases of vocal cord paralysis, only one vocal cord is paralyzed. If both of your vocal cords are affected, you may have vocal difficulties, as well as significant problems with breathing and swallowing.

Signs and symptoms of vocal cord paralysis may include:

• A breathy quality to the voice
• Hoarseness
• Noisy breathing
• Loss of vocal pitch
• Choking or coughing while swallowing food, drink or saliva
• The need to take frequent breaths while speaking
• Inability to speak loudly
• Loss of your gag reflex
• Ineffective coughing
• Frequent throat clearing

When to see a doctor

If you have unexplained, persistent hoarseness for more than two weeks, or if you notice any unexplained voice changes or discomfort, contact your doctor.