Vocal Cord Paralysis

What Is Vocal Cord Paralysis?

Content is medically reviewed by:

Shruti Bangera, Masters In Neurological Physiotherapy, Senior Physiotherapist & SME, Portea

Vocal cord paralysis is a medical condition that occurs when neural impulses are unable to travel through to your voice box, which is responsible for producing your voice.

The muscles get paralysed this way and prevent you from swallowing food and ingesting saliva through the windpipe. Vocal cord paralysis causes are commonly nerve damage stemming from different cancers, viral infections, and surgery. Common treatment methods for vocal cord palsy are surgery and voice therapy.

Your vocal cords resembled two muscle tissues and are located close to the entrance of the windpipe (trachea). Vocal cord paralysis makes one of these muscles unable to move and in rare cases, both.

This leads to vocal cord paralysis symptoms like difficulty breathing, swallowing and speaking. It’s not uncommon to experience a loss of vocal pitch, hoarse breathing, and experience a lack of gag reflex when you are diagnosed with this medical condition.

Types of Vocal Cord Paralysis

There are mainly two types of vocal cord paralysis:

1. Vocal Cord Paresis: When the laryngeal muscles move abnormally due to partial interruption of nerve impulses, the condition is referred to as Vocal Cord Paresis.
2. Vocal Cord Paralysis: When the laryngeal muscles are completely unable to move due to total interruption of nerve impulses to the voice box, the condition is called Vocal Cord Paralysis.

What Are Some of the Vocal Cord Paralysis Causes?

Although doctors don’t know the specific reasons behind vocal cord paralysis, some of the known possible vocal cord paralysis causes in patients are:

• Neck and chest injuries: Trauma to the neck and chest regions may damage the nerves, thus severing the vocal cords or the entire voice box, rendering patients speechless.
• Stroke: A cerebral stroke may damage different areas of the brain and affect the travel of nerve impulses to the voice box.
• Vocal Cord Injuries: Injuries to the vocal cord resulting from surgery on the thyroid, oesophagus, neck, chest, or parathyroid glands, resulting in vocal cord paralysis in patients.

Diagnosis of Vocal Cord Paralysis

Your doctor may initially ask you how long you’ve been facing problems with speech and test your voice and pitch to check speaking. If he suspects the vocal folds are damaged, he may order the following vocal cord paralysis diagnosis tests:

• Laryngeal Electromyography  (LEMG) – This is a vocal cord paralysis diagnostic test which uses pins and needles to be inserted into the skin through the neck. These are used to record the strength and flow of neuromuscular signals from your brain to your vocal cords. A number of speaking exercises will be asked to perform by the doctor which will target those muscles and test their functionality.
• Endoscopy – A small, thin tube is inserted into your throat which includes a tiny camera used to inspect your laryngeal muscles (vocal folds). Any damage to the vocal cords will be screened through this medical procedure.
• Imaging Tests – Imaging tests like CT Scan, X-rays, and MRIs help determine other possible vocal cord paralysis causes in patients. Blood tests may accompany some of these imaging tests for further medical investigation.

Vocal Cord Paralysis Treatment

Vocal cord paralysis treatment will be determined by your doctor based on your medical condition and vocal cord paralysis diagnostic test. These are the following treatment options available for vocal cord paralysis:

Speech Therapy:

A physiotherapist will begin working with you on different vocal cord paralysis exercises which target your speech and weak vocal folds. Speech therapy is very effective for partial vocal cord paralysis as the weak laryngeal muscles are strengthened through various exercises which opens up the breathing as well.

Surgery:

Surgery is recommended for those who see no improvement despite doing the prescribed speech therapy exercises. There are different types of surgery based on the degree and extent of vocal cord paralysis:

• Bulk Injections – Collagen and fillers are injected into your vocal cords to move the affected muscles closer to the voice box or larynx.
• Phonosurgery – The vocal cords are repositioned in this medical procedure through restructuring.
• Tracheotomy – If your vocal folds are too close, your doctor may make an incision in the neck and insert a breathing tube at the opening of the windpipe. This bypasses the air blockage caused by the vocal folds and promotes proper air circulation via the hole in the neck.

When Do You Need Us?

A part of vocal cord paralysis treatment involves regular physiotherapy exercises. It involves performing gentle exercises that don’t stress your vocal cords but instead work on them in a gradual and progressive manner.

Care must be taken when performing some of these exercises and improve breathing, which is where our team of physiotherapists come in. Speech therapy for vocal cord paralysis will speed up the recovery process by improving airflow and blood circulation to the vocal folds, and home remedies may be recommended to improve your current condition.

How We Can Help

Vocal cord paralysis exercises are no cakewalk for those who are new to it. If you are afflicted by vocal cord paralysis and need physiotherapy assistance, our physiotherapy services will come to your aid.

Our physiotherapists visit your home and assess your medical condition. Based on their diagnosis, you will be prescribed the necessary vocal cord paralysis treatment at home.

The physiotherapist will meet you every day and teach you how to perform them. Corrections will be demonstrated whenever you do them wrong, and after your cure for the vocal cord, paralysis progress is charted, based on its results you may be recommended to go for surgery.

Summary

A vocal cord paralysis is not the end of life, and in fact, you can continue to enjoy living a fully functional life after surgery. If you have mild vocal cord paralysis, you may not be able to sing or do voice-based tasks that well but with a bit of practice and regular physiotherapy exercises, your voice box will be back on its feet.

Dietary changes may be recommended based on the results of your surgery, and you will be expected to adhere to them.

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