Summary about Disease
Unilateral vocal cord paralysis (UVCP) occurs when one of the vocal cords is unable to move. This immobility is typically due to nerve damage affecting the recurrent laryngeal nerve, which controls vocal cord movement. This paralysis affects voice production, breathing, and swallowing. The impact of UVCP varies depending on the position of the paralyzed vocal cord and the effectiveness of the remaining mobile vocal cord.
Symptoms
Hoarseness or breathy voice
Difficulty projecting voice
Fatigue when speaking
Changes in voice pitch
Coughing or choking while eating or drinking
Shortness of breath, especially during exertion
Weak cough
Reduced vocal range
Globus sensation (feeling of something stuck in the throat)
Causes
Surgery: Most common cause, particularly thyroid surgery, carotid artery surgery, neck surgery, or lung surgery.
Tumors: Growths in the neck, chest, or brain can compress or damage the nerves controlling the vocal cords.
Viral Infections: Certain viral infections can affect the nerves.
Neurological Conditions: Conditions like stroke, multiple sclerosis, or Parkinson's disease.
Trauma: Injury to the neck or chest.
Idiopathic: In some cases, the cause is unknown.
Medicine Used
There is no specific medication to directly cure vocal cord paralysis. Treatment focuses on managing symptoms and improving vocal cord function.
Proton pump inhibitors (PPIs) or H2 blockers: If acid reflux is contributing to the problem.
Corticosteroids: Occasionally used to reduce inflammation if nerve damage is recent, but their efficacy is debated. Note: Surgical or therapeutic procedures are usually considered, rather than medication.
Is Communicable
No, unilateral vocal cord paralysis is not a communicable disease. It is not caused by an infectious agent and cannot be transmitted from person to person.
Precautions
Voice Therapy: Following the guidance of a speech-language pathologist is crucial for improving voice quality and preventing further strain.
Hydration: Staying well-hydrated helps to keep the vocal cords lubricated.
Vocal Rest: Avoiding excessive talking or shouting can prevent further irritation.
Acid Reflux Management: If acid reflux is a contributing factor, managing it through diet, lifestyle changes, or medication is important.
Proper Swallowing Techniques: Working with a speech-language pathologist to learn safe swallowing techniques can reduce the risk of aspiration (food or liquid entering the lungs).
Avoid Irritants: Limiting exposure to smoke, fumes, and other respiratory irritants.
How long does an outbreak last?
UVCP is not an outbreak, it's a chronic condition. The duration of symptoms and the prognosis depend on the underlying cause, the degree of nerve damage, and the effectiveness of treatment. Some individuals may experience improvement over time, while others may require long-term management.
How is it diagnosed?
Medical History and Physical Exam: The doctor will ask about your symptoms, medical history, and perform a physical examination.
Laryngoscopy: A procedure where a thin, flexible tube with a camera (laryngoscope) is inserted through the nose or mouth to visualize the vocal cords.
Stroboscopy: A special type of laryngoscopy that uses a strobe light to visualize vocal cord vibration.
Laryngeal Electromyography (LEMG): This test measures the electrical activity of the muscles in the larynx (voice box). It can help determine the extent of nerve damage.
Imaging Studies: CT scans or MRI scans may be used to identify tumors, nerve compression, or other structural abnormalities.
Timeline of Symptoms
The timeline of symptoms varies depending on the cause.
Post-Surgical: Symptoms often appear immediately after surgery.
Viral Infection: Symptoms may develop gradually over a few days or weeks.
Tumor: Symptoms may develop slowly and progressively as the tumor grows.
Trauma: Symptoms appear immediately after the injury. The persistence of symptoms will depend on the underlying cause, severity, and intervention. In some cases, spontaneous recovery may occur within 6-12 months.
Important Considerations
Early Diagnosis and Treatment: Early diagnosis and appropriate management are crucial for optimizing outcomes.
Multidisciplinary Approach: Management often requires a team approach involving otolaryngologists (ENT doctors), speech-language pathologists, neurologists, and other specialists.
Aspiration Risk: Individuals with UVCP are at risk of aspiration pneumonia, especially if swallowing is significantly impaired.
Voice Therapy is Key: Voice therapy is often the cornerstone of treatment, helping patients to improve voice quality, reduce strain, and compensate for the paralyzed vocal cord.
Surgical Options: Surgical options, such as vocal cord injection, medialization thyroplasty, or reinnervation procedures, may be considered if voice therapy is not sufficient.
Emotional Impact: UVCP can have a significant emotional impact, affecting communication, self-esteem, and quality of life. Support groups and counseling may be helpful.