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.