Vocal Cord Paralysis
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University of Pittsburgh *
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Medicine
Date
Feb 20, 2024
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Uploaded by JudgeNewtPerson1055
The vocal folds are critical to major aspects of our everyday lives. These folds
work to keep us safe while eating by closing tightly over the trachea to ensure proper swallowing and play a major role in phonation to allow us to talk. Proper functioning of these structures is necessary for healthy swallowing, breathing, and speaking. When the vocal folds are paralyzed, there are many complications that can arise. Fortunately, with the help of speech language pathologists, there are treatment options available.
Vocal fold paralysis can manifest in two forms: unilateral and bilateral. Unilateral paralysis occurs on one vocal fold and is more common and less severe than bilateral paralysis. Symptoms of paralysis range from mild to severe depending
on the type of paralysis. Unilateral vocal fold paralysis may result in voice problems such as hoarseness, breathy voice, lack of volume, and limited pitch. If the vocal folds are preventing the person from breathing properly, they will not be able to produce speech for long amounts of time (
Vocal Fold Paralysis, n.d.) Along with voice deficits, vocal fold paralysis may cause choking or coughing while eating because the folds are not able to close tightly enough to prevent food from entering
the trachea (
Vocal Fold Paralysis
, 2017). Additionally, pneumonia could develop if food and liquid continue to make their way to the lungs due to improper protection of the paralyzed vocal folds (
Vocal Fold Paralysis, n.d.).
Complications from unilateral paralysis differ from bilateral paralysis because there is still a functional fold that can open and close as needed. In bilateral paralysis, there is life threatening potential (
Vocal Fold Paralysis
, 2017). If the folds are paralyzed in a position that is blocking the airway, the paramedian position, and
preventing the client from breathing, emergency measures may be needed to give the patient another way to breathe (
Bilateral Vocal Fold Paralysis, n.d.). Some
options may be a tracheostomy in which the patient will have to breathe through a tube inserted into the trachea to bypass the vocal folds that are blocking the airway
(Bhatti, 2023). Bilateral paralysis can also occur when the vocal cords are in an open position. This would not be life threatening and would likely result in the same treatment measures as unilateral paralysis (
Bilateral Vocal Fold Paralysis, n.d.). For less severe cases of vocal fold paralysis, there are less extreme measure of treatment available. For those struggling with changes in voice and difficulty breathing, a speech therapist can provide exercises and strategies to help the client
strengthen their vocal cords and improve breath control while speaking (
Vocal Fold Paralysis
, 2017). The speech therapist will prevent the client from using abnormal muscles around the paralyzed vocal cord and ensure they are using the proper muscles needed for speech to prevent further complications. If therapy is not effective, there are surgical options available. With surgery, the paralyzed cord is repositioned to be closer to the functioning cord to allow for more vibration within the voice box to improve phonation (
Vocal Cord Paralysis Treatment NYC, n.d.). Vocal folds are essential to healthy living and when compromised, many complications occur. Unilateral paralysis is the paralysis of one vocal fold and is more common and less severe than bilateral paralysis. Bilateral paralysis is rare but potentially life threatening if the folds are paralyzed in a position that blocks the airway. Symptoms range from mild to severe depending on the level of paralysis and positioning. Treatments options are available with the help of speech language pathologist and other medical professionals to help strengthen and restore these structures to the best of their ability to allow healthy swallowing, breathing, and speaking again.
References
Bhatti, N. (2023, April 11). Tracheostomy
. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/
tracheostomy#:~:text=Tracheostomy%20is%20a%20procedure%20to,tube%20inserted
%20in%20the%20opening. Bilateral Vocal Fold Paralysis
. Atrium Health Wake Forest Baptist. (n.d.). https://www.wakehealth.edu/condition/b/bilateral-vocal-fold-paralysis#:~:text=Referring
%20Physicians-,Bilateral%20vocal%20fold%20paralysis%20is%20a%20disorder
%20characterized%20by%20complete,)%2C%20producing%20an%20airway
%20obstruction. Vocal Cord Paralysis Treatment NYC
. Mount Sinai Health System. (n.d.). https://www.mountsinai.org/locations/grabscheid-voice-swallowing-center/conditions/
vocal-cord-paralysis Vocal Fold Paralysis
. American Speech-Language-Hearing Association. (n.d.). https://www.asha.org/public/speech/disorders/vocal-fold-paralysis/ Vocal Fold Paralysis
. National Institute of Deafness and Other Communication Disorders. (2017, March 6). https://www.nidcd.nih.gov/health/vocal-fold-paralysis
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