Vocal Cord Paralysis (Voice Box Weakness)
Description
The vocal cords are located in the larynx and vibrate to produce sounds. They also prevent food from entering the airway during swallowing. There are two cords and if both become paralyzed the airway can become obstructed. This requires emergent treatment. If only one is weakened patients have more problems with speech. The disorder can occur from the following: direct trauma to the cords, chest or neck surgery with an injury to the nerve supplying the cords, multiple sclerosis, stroke, and tumors.
Symptoms
Hoarseness, difficulty speaking, difficulty swallowing. Airway obstruction can occur if both cords become paralyzed.
Tests
A history and physical exam will be performed. The diagnosis is made by directly examining the vocal cords with a fiber optic scope (laryngoscopy).
- CT Scan
- MRI
Treatment
Therapy depends on the cause and severity of the injury. Treatment may include: observation, speech therapy, inhaled steroids, and/or surgery. In acute cases of bilateral vocal cord paralysis an emergent tracheotomy may need to be done to allow for breathing.
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