Summary about Disease
Vocal cord paralysis occurs when one or both of your vocal cords don't open or close properly. This can cause voice changes, difficulty breathing, and problems swallowing. It happens when the nerve impulses to your larynx (voice box) are disrupted, leading to paralysis of the vocal cord muscles. Paralysis can affect one (unilateral) or both (bilateral) vocal cords.
Symptoms
Common symptoms include:
Hoarseness or a breathy voice
Loss of voice volume
Frequent throat clearing
Difficulty breathing or shortness of breath
Noisy breathing (stridor)
Coughing or choking while eating or drinking
Changes in pitch
Inability to speak loudly
Reduced stamina when speaking
Causes
Vocal cord paralysis can result from several factors:
Surgery: Damage to the laryngeal nerves during surgeries near the neck or chest (e.g., thyroid surgery, carotid artery surgery, lung surgery, or neck surgery).
Tumors: Tumors growing in or around the larynx, thyroid gland, lung, or esophagus can compress or invade the nerves that control the vocal cords.
Stroke: A stroke can damage the areas of the brain that control the vocal cords.
Neurological conditions: Conditions like multiple sclerosis, Parkinson's disease, myasthenia gravis, and amyotrophic lateral sclerosis (ALS) can affect nerve function.
Infections: Viral infections, such as Lyme disease, herpes simplex virus, Epstein-Barr virus (EBV), and others, can cause nerve damage.
Injury: Trauma to the neck or chest can injure the nerves that control the vocal cords.
Idiopathic: In some cases, the cause of vocal cord paralysis is unknown.
Medicine Used
There is no medicine that directly cures vocal cord paralysis. Treatment focuses on managing symptoms and addressing the underlying cause, if known. Medications may be used to treat related issues like acid reflux. Voice therapy is often used to improve voice and swallowing function.
Is Communicable
Vocal cord paralysis itself is not communicable. However, if the paralysis is caused by an infection, the infection itself might be communicable, but the resulting paralysis is not directly transmitted.
Precautions
Precautions depend on the underlying cause and the severity of symptoms. General precautions include:
Following doctor's recommendations for managing any underlying medical conditions.
Working with a speech-language pathologist for voice therapy.
Being careful while eating and drinking to avoid choking (e.g., taking small bites, chewing thoroughly).
Avoiding irritants like smoke, fumes, and allergens.
Using humidifiers to keep the vocal cords moist.
Protecting the airway if breathing is severely compromised.
How long does an outbreak last?
Vocal cord paralysis is not an "outbreak." It is a condition that can be either temporary or permanent, depending on the cause and the effectiveness of treatment. If the paralysis is due to a temporary issue (e.g., a viral infection that resolves), recovery may occur within weeks to months. In other cases, the paralysis may be permanent, requiring ongoing management.
How is it diagnosed?
Diagnosis typically involves:
Medical history and physical exam: The doctor will ask about your symptoms, medical history, and any potential causes.
Laryngoscopy: A procedure where the doctor uses a small scope with a light to view the vocal cords. This can be done with a flexible scope through the nose (flexible laryngoscopy) or a rigid scope through the mouth (rigid laryngoscopy).
Laryngeal electromyography (LEMG): This test measures the electrical activity in the laryngeal muscles and can help determine the extent and cause of nerve damage.
Imaging studies: CT scans or MRI scans of the head, neck, or chest may be ordered to look for tumors or other abnormalities that could be causing the paralysis.
Voice evaluation: A speech-language pathologist will assess your voice quality, pitch, loudness, and other aspects of your voice to help determine the severity of the paralysis.
Timeline of Symptoms
The onset of symptoms can vary depending on the cause.
Sudden onset: In cases of stroke, injury, or certain infections, symptoms may appear suddenly.
Gradual onset: With tumors or neurological conditions, symptoms may develop gradually over time.
Post-surgical: Symptoms may be noticed immediately after surgery. The duration of symptoms depends on whether the condition is temporary or permanent and the effectiveness of any treatment.
Important Considerations
Airway safety: Bilateral vocal cord paralysis can be life-threatening if both vocal cords are paralyzed in a closed position, obstructing the airway.
Swallowing difficulties: Paralysis can lead to aspiration (food or liquid entering the lungs), increasing the risk of pneumonia.
Voice quality: Even with treatment, some individuals may experience persistent voice changes.
Underlying cause: Identifying and addressing the underlying cause is crucial for managing the condition and preventing further complications.
Multidisciplinary approach: Management often requires a team of specialists, including otolaryngologists (ENT doctors), neurologists, speech-language pathologists, and pulmonologists.