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Vocal Cord ParalysisAka: Laryngeal Nerve Palsy, Laryngeal Paralysis
- See Also
- Causes of Unilateral Vocal Cord Paralysis
- Tumor
- Medications
- Vincristine
- Phenytoin
- Inflammation or Infection
- Collagen vascular disease
- Lyme Disease
- Mononucleosis
- Sarcoidosis
- Toxic and Metabolic Causes
- Diabetes Mellitus
- Alcoholism
- Heavy metal exposure
- Arsenic poisoning
- Mercury Poisoning
- Lead Poisoning
- Trauma
- Intubation
- Post-surgical
- Carotid surgery
- Neck dissection for head and neck cancer
- Cardiac surgery
- Patent Ductus Arteriosus ligation (newborns)
- Valve repair
- Thyroid surgery
- Tracheal surgery
- Symptoms
- Hoarseness
- Decreased endurance for speech and voice Fatigue
- Swallowing difficulty or Choking on liquids
- Singing difficulty
- Signs: Laryngoscopy
- Paralyzed vocal cord is fixed in paramedian position
- Just lateral to midline
- Slight adduction may be seen (collateral innervation)
- Paralyzed vocal cord is bowed and flaccid
- When speaking, drops lower than the unaffected cord
- Uninvolved vocal fold may compensate
- Uninvolved cord crosses midline over next 2-3 months
- Meets paralyzed cord
- Paralyzed vocal cord is fixed in paramedian position
- Evaluation
- See Speech Exam
- Careful lymph node examination
- Radiology
- Chest XRay (consider lordotic views)
- Management: General
- Laryngology or ENT referral in most cases
- Early speech pathology for voice building Exercises
- Management: Surgery for unilaterally paralyzed vocal cord
- Medialization Laryngoplasty (Thyroplasty) with implant
- Various implant types (e.g. Gore-Tex, Silicon)
- Medialization via office injection
- Collagen injections
- Avoid Teflon augmentation due to granulation
- Reinnervation
- Requires more time to result than other procedures
- Medialization Laryngoplasty (Thyroplasty) with implant
- Complications
- Aspiration of food contents
- Resources
- Voice Doctor Website (Dr. Thomas)
- References
Laryngeal Paralysis (C0086523) | |
|---|---|
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 478.30 |
| English | Laryngeal Paralyses, Laryngeal Paralysis, LARYNGOPARALYSIS, Laryngoplegia, Larynx paralysis, Paralysis of larynx, Paralysis of larynx unspecified |
| Spanish | laringoplejia, paralisis de la laringe, paralisis de laringe no especificada, paralisis laringea |
| Parent Concepts | Laryngeal Diseases (C0023051), Vocal Cord Paralysis (C0042928) |
| Sources | CST, MSH, MTHICD9, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
