Vocal cord paralysis

Vocal cord paralysis

Vocal cords or vocal folds are the twin foldings of mucus membrane which run horizontally across larynx. They are responsible for generating voice. Weakness of the muscles supporting these cords or impaired nerve supply result in vocal cord paralysis. Vocal cords also help in preventing food, liquids or even saliva from entering into trachea and thus prevent choking. They are open during inhalation, closed when one holds his breath and vibrate during speech or singing.

Causes and risk factors

Movements of vocal cord are controlled by vagus nerve. Disruption of nerve impulses to the larynx result in paralysis of muscles of vocal cord. Vocal cord paralysis can occur due to various reasons such as injury to the vocal cords during surgery of thyroid, parathyroid gland; injury or compression of recurrent laryngeal nerve , injury due to intubation during surgery; injury to the neck or chest, stroke, tumours, inflammation causing scarring of the vocal cords, viral infections, neurological diseases such as Parkinson’s, stress.

Clinical presentation

When vocal cords come together and vibrate voice is produced. In paralysis of vocal cords usually only one cord is affected. It results in hoarseness, noisy breathing,  choking while eating or drinking, loss of high pitch sound, ineffective coughing, need to clear the throat frequently.

Investigation

Medical history by the patient and Clinical examination by the doctor helps in diagnosis. laryngoscope will reveal reduced motion of one or both the cords, EMG electromyography can diagnose the strength of neuromuscular signals controlling vocal cords.

Treatment

Voice therapy involves exercises of vocal cords. Bulk injection adds bulk to the paralyzed vocal cord which brings them to the centre of voice box thus their movement makes closer contact with affected vocal cord and help in generating voice. Surgical implants, vocal cord repositioning helps when vocal cords are physically damaged, reinnervation i.e. replacement of damaged nerve help in treating vocal cord paralysis. Psychotherapy helps for emotional causes of vocal cord paralysis. Inflammation can resolve in few days.

Other Modes of treatment

The other modes of treatment can also be effective in treating vocal cord paralysis.

Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating vocal cord paralysis.

Recent updates

Linking of vocal cord to another source of electrical stimulation or nerve from other body part is under study for the treatment of vocal cord paralysis.

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