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Vocal fold paresis and paralysis Vocal cord nerve damage results in weakness and hypomobility of the vocal fold. A single sided (unilateral) vocal cord weakness is much more common than one that occurs on both sides (bilateral). The vocal cords no longer come together when trying to speak or swallow leaving a gap. What are typical symptoms of a paralyzed vocal cord?
Vocal fold paresis and paralysis can be related to a number of underlying causes including:
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The left vocal cord (right side on image) is immobile after thyroid surgery lead to injury of the vocal cord nerve
The vocal cords are not closing when speaking and are leaking air. The patient is hoarse and has trouble swallowing.
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How do we treat the paralyzed vocal fold on one side?
Treatment for a one-sided vocal fold paralysis depends on a number of things. It may consist of a temporary or permanent medialisation of the involved vocal cord.
Injection laryngoplasty: this procedure is usually done in the office with very minimal discomfort for the patient. It entails injection of a dissolvable material (e.g. hyaluronic acid or hydroxy apatite) into the paralyzed vocal fold. Depending on the chosen injectable material the effect lasts anywhere from 2-8 months
Medialisation thyroplasty: An implant is inserted into the voicebox to push the vocal into a favorable position. In contrast to the injection laryngoplasty this procedure is meant to have a permanent effect. It is sometimes combined with repositioning of the vocal fold joint (arytenoidpexy/ arytenoid adduction)
How do we treat the paralyzed vocal folds on both sides?
An inadequate airway with breathing problems is a significant concern in this patient population. The decision-making process is often complex and may include surgeries to open the vocal folds. Dr. Weidenbecher has developed an endoscopic technique to reconstruct the voice box, which allows some patients to regain vocal cord function. In severely scarred cases this may not be possible and Dr. Weidenbecher may choose other surgical steps, such as a partial cordotomy (small opening into the vocal cord) to improve breathing.
Treatment for a one-sided vocal fold paralysis depends on a number of things. It may consist of a temporary or permanent medialisation of the involved vocal cord.
Injection laryngoplasty: this procedure is usually done in the office with very minimal discomfort for the patient. It entails injection of a dissolvable material (e.g. hyaluronic acid or hydroxy apatite) into the paralyzed vocal fold. Depending on the chosen injectable material the effect lasts anywhere from 2-8 months
Medialisation thyroplasty: An implant is inserted into the voicebox to push the vocal into a favorable position. In contrast to the injection laryngoplasty this procedure is meant to have a permanent effect. It is sometimes combined with repositioning of the vocal fold joint (arytenoidpexy/ arytenoid adduction)
How do we treat the paralyzed vocal folds on both sides?
An inadequate airway with breathing problems is a significant concern in this patient population. The decision-making process is often complex and may include surgeries to open the vocal folds. Dr. Weidenbecher has developed an endoscopic technique to reconstruct the voice box, which allows some patients to regain vocal cord function. In severely scarred cases this may not be possible and Dr. Weidenbecher may choose other surgical steps, such as a partial cordotomy (small opening into the vocal cord) to improve breathing.