Thursday, July 12, 2018 by Zoey Sky
Vocal fold paralysis occurs when one or both of a patient’s vocal folds stop working.
The vocal folds (or vocal cords) are two flexible bands of muscle tissue that can be found at the entrance to the trachea/windpipe.
One or both vocal folds can be paralyzed when a patient has vocal fold paralysis.
- Unilateral vocal cord paralysis – This occurs when a patient has a single paralyzed vocal fold. Unilateral vocal paralysis affects an individual’s voice. It can also affect a patient’s ability to swallow properly.
- Bilateral vocal cord paralysis – This occurs when both vocal folds are paralyzed. Bilateral vocal cord paralysis can significantly affect a person’s airway and breathing.
Vocal fold paralysis is also called vocal cord paresis.
Known symptoms of vocal fold paralysis
The signs of vocal fold paralysis usually include:
- Changes to the voice – The voice may become more “breathy”/sound like a loud whisper.
- Changes to vocal pitch
- Choking – This may occur when swallowing solids or liquids, or when swallowing saliva.
- Coughs that don’t clear the throat properly
- Hoarseness/ huskiness
- Loss of the gag reflex/pharyngeal reflex
- Noisy breathing
- Running out of breath when speaking
- Voice volume – In some cases, the patient may have trouble raising their voice.
Risk factors for vocal fold paralysis may include:
- Certain neurological conditions – Patients with multiple sclerosis (MS), myasthenia gravis, or Parkinson’s disease have a higher risk of developing vocal cord paralysis. There is a higher risk for vocal cord weakness compared to paralysis.
- Some types of surgery – Specifically, chest or throat surgery. The breathing tubes used in surgery can damage vocal cord nerves. Cardiac surgery can affect normal voice function since the nerves connected to the larynx are routed near the heart. This nerve can sometimes be damaged during open heart surgery. Meanwhile, the recurrent laryngeal nerve can be found near the thyroid gland, and hoarseness because of partial paralysis can be a side effect of thyroid surgery.
Body systems harmed by vocal fold paralysis
Vocal fold paralysis may cause the following complications:
- Aspiration – Aspiration occurs when a person breathes in a foreign object. There is paralysis in the area where food or liquid goes down, and this may cause choking. Aspiration can also cause severe pneumonia.
- Breathing difficulty– A patient experiencing severe signs due to the condition may suffer from fatal breathing problems.
Food items or nutrients that may prevent vocal fold paralysis
The following foods or nutrients can help prevent vocal fold paralysis or address its signs:
- Hydrating foods – Hydration is important to maintain a healthy voice. Aside from drinking at least eight glasses of non-caffeinated fluids a day, increase your consumption of fruits and vegetables that are naturally high in water. Sources include apples, celery, cucumber, grapes, peaches, and raw tomatoes.
- Vitamin A – This essential vitamin can help keep the mucous membranes, soft tissue, and skin healthy. Healthy mucous membranes, like those in the throat, is important for overall throat health. Sources of vitamin A include eggs and meat (especially liver, dark, leafy greens (like kale and spinach), and yellow and orange fruits and vegetables (like apricots, cantaloupe, carrots, and orange sweet peppers).
Treatments, management plans for vocal fold paralysis
Treatment for vocal cord paralysis will depend on several factors like the cause of the condition, the severity of signs, and how long the signs have been present.
Treatment options include voice therapy, surgery, or both.
Like physical therapy for large muscle paralysis, voice therapy helps address vocal fold paralysis. A therapist may ask the patient to try special exercise and other activities that can:
- Strengthen the vocal cords;
- Improve breath and control while speaking;
- Prevent unusual tensions in other muscles near the affected vocal cord(s); and
- Protect the airway from liquids and solids.
If voice therapy doesn’t help the patient fully recover from the condition, they may need surgical intervention. Surgical options include:
- Bulk injection – If the vocal cord muscle is weak because of nerve paralysis, an otolaryngologist (ear, nose, and throat specialist doctor) will inject collagen, fat, or some filler into the vocal cord. The filler can help bring the vocal cord closer to the middle of the larynx/voice box, so the opposite cord muscle can move more easily and effectively when the patient coughs, speaks, or swallows.
- Phonosurgery/vocal cord repositioning – This procedure repositions and/or reshapes the vocal fold to improve voice functions.
- Tracheotomy – If both vocal folds are affected and are very close to each other, the decreased air flow can cause breathing difficulties.
Where to learn more
Summary
Vocal fold paralysis occurs when one or both of a patient’s vocal folds stop working.
The symptoms of vocal fold paralysis usually include changes to the voice, changes to vocal pitch, and choking.
Vocal fold paralysis may cause complications like aspiration and breathing difficulty.
Hydrating foods and vitamin A can help prevent vocal fold paralysis or address its symptoms.
Treatment for vocal cord paralysis will depend on several factors like the cause of the condition, the severity of symptoms, and how long the symptoms have been present. Treatment options include voice therapy, surgery, or both.
Sources include:
UOfM.com
MedicalNewsToday.com
Livestrong.com