CLEVELAND VOICE AND SLEEP
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​Vocal Fold Paralysis 

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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?
  • Weak and breathy voice
  • High-pitches voice
  • Inability to talk loud
  • Early voice fatigue
  • Running out of air when talking
  • Getting out of breath on exertion
 
Vocal fold  paresis and paralysis can be related to a number of underlying causes including:
  • Post viral ( after an upper respiratory infection)
  • Previous neck surgery (e.g. thyroid, parathyroid, heart, carotid and anterior cervical spine surgery)
  • Tumors (e.g lung cancer)
  • Stroke
  • Idiopathic (non-identifiable cause)
Picture
The left vocal cord (right side on image) is immobile after thyroid surgery lead to injury of the vocal cord nerve
Picture
The vocal cords are not closing when speaking and are leaking air. The patient is hoarse and has trouble swallowing.
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) 
 
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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. 
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Our Office Locations

MetroHealth Medical Center
2500 Metrohealth Dr.
​Cleveland, OH 44109​
MetroHealth Parma Health Center
12301 Snow Rd
​Parma, OH 44130

Contact

P (216) 778-4174
F (216) 957-0434
​email: clevelandvoiceandsleep@gmail.com
  • Home
  • About
  • Services
    • Sleep Apnea and Snoring
    • Laryngeal Cancer Surgery
    • Complex Airway Surgery
    • Vocal Cord Microsurgery
    • Office-Based Procedures
  • Sleep
    • Surgical Therapy
    • Inspire Therapy
    • Throat Surgery
    • Non-Surgical Therapy
  • Voice
    • Anatomy & Physiology
    • Benign Vocal Cord Lesions
    • Vocal Cord Paralysis
    • Laryngeal Papilloma
    • Reinke’s Edema
    • Spasmodic Dysphonia
    • Granuloma
  • Airway
    • Airway Stenosis
  • Cancer
    • Laryngeal Cancer
  • Transgender
    • Tracheal Shave
    • Transgender Voice
  • Contact