Vocal Fold Paralysis and Vocal Fold Paresis

When the recurrent laryngeal nerve is injured, the vocal fold may be paralyzed. In this situation, it does not move at all. 

A vocal fold paralysis on one side usually leads to significant voice problems and sometimes trouble swallowing liquids. This is because the vocal folds cannot close completely, leaving a gap between them. 

When both vocal folds are paralyzed, breathing is a major concern, since the vocal folds cannot open adequately to allow comfortable breathing. A tracheotomy (breathing tube in the neck) may be necessary when both vocal folds are paralyzed. 

Causes of Vocal Fold Paralysis

The most common cause of unilateral vocal fold paralysis is surgery. Since the recurrent laryngeal nerve has a long course through the neck and chest, it is vulnerable to injury from many types of surgeries, particularly thyroid, chest and esophageal, and cervical spine surgeries. Tumors located anywhere along the course of the recurrent laryngeal nerve may also cause vocal fold paralysis, so your surgeon may order imaging studies to rule out lung cancer or other types of cancers. Other causes of vocal fold paralysis include viral infections and trauma. Sometimes the cause of the vocal fold paralysis cannot be determined.

Nerve injury is not the only cause of vocal fold immobility. Trauma can disrupt the joint of the vocal fold, causing fixation of the vocal fold. Laryngeal electromyography (LEMG) can be used to measure the nerve activity to the vocal folds. This allows your surgeon to determine if the vocal fold is paralyzed (nerve injury) or fixated (joint injury). LEMG also gives information about the potential for a nerve injury to recover on its own. 

Vocal Fold Paresis

A weakness of the vocal fold (paresis) without total paralysis is a much more common scenario, with the most common cause being viral infections. Often, vocal fold paresis affects both vocal folds. LEMG is particularly useful in making this diagnosis, in combination with the laryngeal examination and a speech pathology evaluation. The treatments for vocal fold paresis are often similar to the treatments for vocal fold paralysis. 

Make an Appointment

If you are suffering from vocal fold paresis or paralysis call 716-WAKE or request an appointment online.

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Last Updated: 08-27-2014
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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.