Vocal cord paresis and paralysis result from deviant nerve involvement to the voice box muscles. Paralysis is the complete disturbance of nerve impulse resulting in no movement of the muscle; Paresis is limited interruption of nerve impulse resulting in frail or peculiar activity of laryngeal muscle(s). Vocal fold movements are an outcome of synchronized spasm of assorted muscles. These muscles are controlled by the brain through a precise set of nerves. The nerves that accept these signals are the: Superior laryngeal nerve (SLN), which carries signals to the cricothyroid muscle, located between the cricoid and thyroid cartilages and the Recurrent laryngeal nerve (RLN) carries signals to different voice box muscles responsible for opening vocal folds (as in breathing, coughing), closing vocal folds for vocal fold vibration during voice use, and closing vocal folds during swallowing. Even with advances in diagnostic technology, physicians are unable to detect the cause in about half of all vocal fold paralyses. These cases are referred to as idiopathic (due to unknown origins). Known reasons for injury can include:
Inadvertent injury during surgery
Complication from endotracheal intubation
Blunt neck or chest trauma
Tumors of the skull base, neck, and chest
Tumors of the skull base, neck, and chest
Symptoms of Vocal Fold Paralysis/Paresis consist of:
Voice changes
Airway problems
Swallowing problems
Determining whether one or both vocal folds are affected is critical in the treatment plan. The two treatment strategies to enhance vocal function are voice therapy, the equivalent of physical therapy for large muscle paresis/paralysis; and phonosurgery, an operation that repositions and/or reshapes the vocal fold(s) to improve voice function.
http://www.entlink.net/HealthInformation/vocalChordParalysis.cfm
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