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Vocal cord paresis

 

 
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Vocal cord paresis
 
 
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Vocal cord paresis (or paralysis) is weakness of one or both vocal folds
Vocal folds

The vocal folds, also known commonly as vocal cords, are composed of twin infoldings of mucous membrane stretched horizontally across the larynx....
 that can greatly impact daily life, employment
Employment

Employment is a contract between two party , one being the #Employer and the other being the #Employee. An employee may be defined as: "A person in the Service of another under any contract of hire, express or implied, oral contract or written, where the employer has the power or right to control and Management the employee i...
, job choice, social interaction
Social interaction

Social interaction is a dynamic, changing sequence of social actions between individuals who modify their actions and reactions according to those of their interaction partner....
s and leisure time pursuits. Symptoms of paresis
Paresis

Paresis is a condition typified by partial loss of movement, or impaired movement. When used without qualifiers, it usually refers to the limbs, but it also can be used to describe the muscles of the eyes and also the stomach ....
 include: hoarseness, vocal fatigue, mild to severe reduction in vocal volume, pain in the throat when speaking, shortness of breath, aspiration
Aspiration

Aspiration may refer to:*Aspiration , the release of a strong burst of air after some obstruents*Engine aspiration method:**Naturally-aspirated engine, an internal combustion engine that relies on atmospheric pressure for air intake...
 (food or liquids going down the trachea) with frequent resultant coughing, and in extreme cases may cause death.

Reduced vocal cord mobility may decrease the effectiveness of coughing, swallowing, or sneezing in removing mucosal wastes from the laryngeal area.






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Encyclopedia


Vocal cord paresis (or paralysis) is weakness of one or both vocal folds
Vocal folds

The vocal folds, also known commonly as vocal cords, are composed of twin infoldings of mucous membrane stretched horizontally across the larynx....
 that can greatly impact daily life, employment
Employment

Employment is a contract between two party , one being the #Employer and the other being the #Employee. An employee may be defined as: "A person in the Service of another under any contract of hire, express or implied, oral contract or written, where the employer has the power or right to control and Management the employee i...
, job choice, social interaction
Social interaction

Social interaction is a dynamic, changing sequence of social actions between individuals who modify their actions and reactions according to those of their interaction partner....
s and leisure time pursuits. Symptoms of paresis
Paresis

Paresis is a condition typified by partial loss of movement, or impaired movement. When used without qualifiers, it usually refers to the limbs, but it also can be used to describe the muscles of the eyes and also the stomach ....
 include: hoarseness, vocal fatigue, mild to severe reduction in vocal volume, pain in the throat when speaking, shortness of breath, aspiration
Aspiration

Aspiration may refer to:*Aspiration , the release of a strong burst of air after some obstruents*Engine aspiration method:**Naturally-aspirated engine, an internal combustion engine that relies on atmospheric pressure for air intake...
 (food or liquids going down the trachea) with frequent resultant coughing, and in extreme cases may cause death.

Reduced vocal cord mobility may decrease the effectiveness of coughing, swallowing, or sneezing in removing mucosal wastes from the laryngeal area. The resultant accumulations may allow for viral and bacterial colonization with an increased tendency for infections and throat discomfort.

Some causes of paresis include: viral infection, cancer
Cancer

Cancer is a class of diseases in which a group of cell display uncontrolled growth , invasion , and sometimes metastasis . These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize....
 or tumor
Tumor

A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells . Tumor is not synonymous with cancer. A tumor can be Benign neoplasm, Carcinoma in situ or malignant, whereas cancer is by definition malignant....
 compressing the recurrent laryngeal nerve, intramuscular tumor limiting vocal fold movement, trauma
Physical trauma

Physical trauma refers to a body injury. A trauma patient is someone who has suffered serious and life-threatening physical injury with the potential for secondary complications such as Shock , respiratory failure and death....
, compression of the vocal cord nerve from intubation
Intubation

In medicine, intubation refers to the placement of a tube into an external or internal orifice of the body. Although the term can refer to endoscopy procedures, it is most often used to denote tracheal intubation....
, or laryngopharyngeal reflux
Laryngopharyngeal reflux

Laryngopharyngeal reflux refers to the backflow of stomach contents into the throat. LPR is also called "silent" reflux, because it usually occurs without heartburn, a symptom that is typical of classical gastroesophageal reflux disease ....
. Cardiac surgery represents a risk to normal voice function as the nerves serving the larynx are routed near the heart. Damage to this nerve during open heart surgery is not uncommon. Neurological diseases, such as Parkinson's can deteriorate vocal functions. Paresis may occur from an unknown cause (idiopathic).

Vocal paresis is diagnosed by observing the lack of (or reduced) motion of one or both cords using a laryngoscope. EMG (electromyography) may be used to measure the strength of the neuromuscular signal from the brain to the muscles controlling the vocal folds. This diagnosis can be made by a laryngologist or otolaryngologist with the assistance of a neurologist. In situations involving inflammation, recovery of normal motion of the vocal cords may return spontaneously.

Emotional and stress factors

The onset of vocal dysfunction may not display a clear physical or disease event. Under such circumstances, additional attention can be directed toward matters of recent emotional concern to the person with voice weakness.

Surgical intervention

In the event of significant voice weakness, surgery may be required to provide temporary or permanent medialization of the vocal cords. These procedures will mechanically move the vocal cord and underlying muscular tissue toward midline (medialize) to allow a stronger "strike" against the opposite vocal cord, thus providing for a stronger and louder voice. The injection of purified animal fat is a temporary means to accomplish medialization. The surgical insertion of "buttons" of sculpted silicone or similar deformable plastic substances just inside the trachea wall will permanently medialize a vocal cord. This procedure is done under local anesthetic, to allow the patient to phonate, thus allowing the surgeon to experiment with the best size and shape of the "button" for maximal remediation. This procedure can be done unilaterally or bilaterally. In all cases, after this surgery, the relaxed position of the vocal cords will allow the passage of less breath than before the medialization. The airway is rendered smaller and this effect must be a significant consideration of the surgeon.

External links

  • at CNN
    CNN

    Cable News Network, almost always referred to by its initialism CNN, is a major US Cable News Network founded in 1980 by Ted Turner. Upon its launch, CNN was the first station to provide 24-hour television news coverage, and the first all-news television network in the United States....
  • at Merck Manual
  • at Mayo Clinic