Summary about Disease
Vocal cord weakness (also known as vocal cord paresis or paralysis) occurs when one or both vocal cords don't move or close properly. This affects your ability to speak, breathe, and swallow. The severity can range from mild hoarseness to life-threatening breathing difficulties. The condition results from nerve damage that controls the vocal cords.
Symptoms
Hoarseness
Breathiness (a whispery voice)
Strained or effortful voice
Reduced vocal pitch or range
Voice fatigue
Coughing or choking while eating or drinking
Difficulty swallowing (dysphagia)
Shortness of breath
Weak cough
Loss of voice (aphonia)
Noisy breathing (stridor, especially with bilateral paralysis)
Causes
Surgery: Thyroid surgery, neck surgery, or chest surgery can damage the nerves controlling the vocal cords.
Neurological Conditions: Stroke, multiple sclerosis, Parkinson's disease, myasthenia gravis, and other neurological disorders can affect nerve function.
Tumors: Tumors in the brain, skull base, neck, or chest can press on or invade the nerves.
Infections: Viral infections (like herpes, Epstein-Barr) can sometimes cause nerve damage.
Trauma: Injury to the head, neck, or chest.
Idiopathic: In some cases, the cause is unknown.
Other medical conditions: such as diabetes or Lyme disease.
Medicine Used
The medicine used often depends on the underlying cause and severity of the vocal cord weakness. There is no single medication to "cure" it. Medications may address underlying conditions, such as:
Steroids: To reduce inflammation if inflammation is suspected to affect nerve function.
Antibiotics or Antivirals: If an infection is the underlying cause.
Botulinum toxin (Botox): Injected into the vocal cord muscles to reduce spasms.
Proton pump inhibitors (PPIs) or H2 blockers: If acid reflux is exacerbating the symptoms.
Voice therapy
Surgery: Laryngoplasty, vocal cord repositioning, vocal cord augmentation, or tracheotomy.
Is Communicable
Vocal cord weakness itself is not communicable. It is not an infectious disease that can be spread from person to person. If a viral infection caused the vocal cord weakness, that underlying infection could be communicable, but the resulting vocal cord weakness is not.
Precautions
Voice Rest: Avoid excessive talking or shouting to prevent further strain.
Hydration: Drink plenty of water to keep vocal cords lubricated.
Avoid Irritants: Limit exposure to smoke, pollutants, and allergens.
Proper Posture: Maintain good posture to support optimal breathing and voice production.
Manage Underlying Conditions: Control conditions like acid reflux or diabetes.
Follow Voice Therapy Recommendations: Adhere to the exercises and techniques prescribed by a speech-language pathologist.
Safe Swallowing Techniques: Implement strategies to prevent choking or aspiration, especially if swallowing is impaired.
How long does an outbreak last?
Vocal cord weakness is not an "outbreak" in the infectious disease sense. The duration of vocal cord weakness varies greatly depending on the cause, severity, and treatment.
Temporary: If caused by a temporary issue like inflammation from a virus, it might resolve in weeks or months.
Persistent: If caused by nerve damage or a neurological condition, it may be long-term or permanent.
Variable: Some people experience improvement with voice therapy and/or surgery.
How is it diagnosed?
Medical History and Physical Exam: The doctor will ask about your symptoms and medical history.
Laryngoscopy: A procedure where a thin, flexible tube with a camera (laryngoscope) is inserted through the nose or mouth to visualize the vocal cords.
Videostroboscopy: A special type of laryngoscopy that uses a strobe light to assess the vibration of the vocal cords.
Laryngeal Electromyography (LEMG): Measures the electrical activity of the muscles in the larynx (voice box).
Imaging Tests: CT scans or MRI scans may be used to identify tumors, structural abnormalities, or nerve damage.
Swallowing Studies: To evaluate swallowing function and identify any aspiration risks.
Voice Assessment: Comprehensive evaluation by a speech-language pathologist.
Timeline of Symptoms
The timeline of symptoms depends heavily on the cause.
Sudden onset: Can occur after surgery or trauma.
Gradual onset: May develop slowly with neurological conditions, tumors, or infections.
Fluctuating symptoms: Some individuals may experience periods of improvement followed by worsening symptoms.
Progressive: If caused by a degenerative condition, symptoms may worsen over time.
Important Considerations
Early Diagnosis: Prompt diagnosis and treatment are crucial to maximize recovery and prevent complications.
Multidisciplinary Approach: Management often requires a team of specialists, including an otolaryngologist (ENT doctor), neurologist, speech-language pathologist, and pulmonologist.
Aspiration Risk: Vocal cord weakness can increase the risk of aspiration (food or liquid entering the lungs), which can lead to pneumonia.
Quality of Life: Vocal cord weakness can significantly impact communication, social interactions, and overall quality of life.
Individualized Treatment: The best treatment approach is tailored to the individual's specific needs and the underlying cause of the vocal cord weakness.
Voice Therapy Commitment: Voice therapy requires consistent effort and practice for optimal results.
Monitor for Changes: Report any new or worsening symptoms to your doctor promptly.