Materiały źródłowe

• #1 Vocal Cord Paralysis: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17624-vocal-cord-paralysis

  Vocal cord paralysis happens when you cant control the muscles that move one or both vocal cords. […] Healthcare providers treat this condition with voice therapy and surgery. […] Vocal cord paralysis involves one or both vocal cords (vocal folds) not moving as they should. […] With vocal cord paralysis, nerve damage prevents the muscles inside your vocal cords from opening and closing properly. […] Medical experts in ear, nose and throat conditions (otolaryngologists), including providers who specialize in conditions involving your throat and voice box (laryngologists), often diagnose and treat vocal cord paralysis. […] To confirm a diagnosis, your provider may order the following: Imaging studies, Laryngoscopy, Videostroboscopy, Laryngeal electromyography (LEMG), Blood tests. […] Treatment depends on the severity of the paralysis and your symptoms.

• #1 Vocal cord paralysis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vocal-cord-paralysis/diagnosis-treatment/drc-20378878

  To diagnose vocal cord paralysis, your healthcare professional asks about your symptoms and lifestyle. Your care professional also listens to your voice and asks how long you’ve had voice changes. You also may need the following tests: […] Your healthcare professional looks at your vocal cords using a mirror or a thin, flexible tube known as a laryngoscope or endoscope, or both. You also may have a test called videostrobolaryngoscopy. It uses a special scope that contains a tiny camera at its tip or a larger camera connected to the scope’s viewing piece. […] This test measures the electrical currents in your voice box muscles. To do this, small needles are inserted into the vocal cord muscles through the skin of the neck. […] Several diseases may cause nerve injuries. You may need additional tests to find the cause of the paralysis. Tests may include bloodwork, X-rays, MRI or CT scans.

• #2 Vocal Fold Paralysis—Symptoms & Treatment | NIDCD

  https://www.nidcd.nih.gov/health/vocal-fold-paralysis

  How is vocal fold paralysis diagnosed? Vocal fold paralysis is usually diagnosed by an otolaryngologist, a doctor who specializes in ear, nose, and throat disorders. He or she will ask you about your symptoms and when the problems began in order to help determine their cause. The otolaryngologist will also listen to your voice to identify breathiness or hoarseness. Using an endoscope, a tube with a light at the end, your doctor will look directly into the throat at the vocal folds. Some doctors also use a procedure called laryngeal electromyography, which measures the electrical impulses of the nerves in the larynx, to better understand the areas of paralysis. […] If you notice any unexplained voice changes or discomfort, you should consult an otolaryngologist or a speech-language pathologist for evaluation and possible treatment.

• #3 What is the diagnosis of Vocal Cord Paralysis? | OnlyMyHealth

  https://www.onlymyhealth.com/what-diagnosis-vocal-cord-paralysis-12977601018

  Vocal cord paralysis is usually diagnosed by an otolaryngologist-a doctor who specializes in ear, nose, and throat disorders. […] The other diagnosis for vocal cord paralysis are laryngeal electromyography, and blood tests and scans. […] Vocal cord paralysis is usually diagnosed by an otolaryngologist-a doctor who specializes in ear, nose, and throat disorders. Noting the symptoms the patient has experienced, the otolaryngologist will ask how and when the voice problems started in order to help determine their cause. Next, the otolaryngologist listens carefully to the patients voice to identify breathiness or harshness. Then, using an endoscopea tube with a light at the endthe otolaryngologist looks directly into the throat at the vocal cords. A speech-language pathologist may also use an acoustic spectrograph, an instrument that measures voice frequency and clarity, to study the patients voice and document its strengths and weaknesses.

• #3 What is the diagnosis of Vocal Cord Paralysis? | OnlyMyHealth

  https://www.onlymyhealth.com/what-diagnosis-vocal-cord-paralysis-12977601018

  The other diagnosis for vocal cord paralysis are laryngeal electromyography, and blood tests and scans. Laryngeal electromyography is done to measure the electric currents in your voice box muscles. The health care professional inserts small needles into your vocal cord muscles through the skin of the neck. However, this test is rarely done as it doesn’t usually provide information that might change the course of treatment. Blood tests and scans are done as there are certain diseases that can cause injury to the nerve. In that case, additional tests are required to identify the cause of the paralysis. Blood tests and scans for vocal cord paralysis include blood work, lung function tests, X-rays, MRI and CT scans.

• #4 Vocal Cord Paralysis – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/laryngeal-disorders/vocal-cord-paralysis

  Diagnosis of vocal cord paralysis is based on laryngoscopy. The cause must always be sought. Evaluation is guided by abnormalities identified on history and physical examination. […] Paralysis is diagnosed by laryngoscopy, but identification of the cause typically requires imaging (eg, MRI) and other tests.

• #5 Unilateral Vocal Fold Paralysis Workup: Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/863779-workup

  However, indirect or direct flexible laryngoscopy remains the gold standard for the diagnosis of UVFP, with evidence existing that CT imaging should not be considered a reliable means for diagnosing this condition. […] A blinded study by Bashir et al suggested that CT scanning is not as accurate a tool for predicting vocal fold paralysis as previous studies have implied. CT scans from two groups of individuals, those who had been diagnosed with UVFP and those with normal vocal fold movement, were examined by three radiologists for eight UVFP signs; the evaluators were unaware of which subjects belonged to which group. […] Voice evaluation by a speech-language pathologist is often helpful to determine the degree of maladaptive compensatory behavior present. In addition, voice recording provides documentation of the baseline voice quality and ability. This is important because treatment for the vocal fold paralysis usually begins shortly after evaluation.

• #5 Unilateral Vocal Fold Paralysis Workup: Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/863779-workup

  LEMG findings can be diagnostic and prognostic and can therefore be a useful tool to guide therapy. LEMG can be used to differentiate between vocal fold immobility caused by cricoarytenoid joint pathology and that caused by vocal fold paralysis. The timing of LEMG is crucial in accurately determining the prognosis of spontaneous recovery of the paralyzed vocal fold. LEMG is most predictive of outcome if performed 6 weeks to 6 months after the onset of symptoms.

• #5 Unilateral Vocal Fold Paralysis Workup: Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/863779-workup

  Although rarely obtained today for the workup of unilateral vocal fold paralysis (UVFP), chest radiography is sometimes the first screening evaluation for a patient with UVFP of unknown etiology, ordered by a physician for other comorbid chest symptoms. This may reveal a chest malignancy as the cause of the UVFP. A Pancoast tumor, a mediastinal mass, or even massive cardiomegaly may be found. The latter has been shown to be a cause of UVFP, albeit rarely, when enlargement of the left atrium results in a stretch injury to the left recurrent laryngeal nerve (Ortner syndrome). […] CT scanning or MRI of the path of the vagus/recurrent laryngeal nerve should be performed as part of a workup for a UVFP of unknown etiology. The imaging should include the entire path of the vagus/recurrent laryngeal nerve involved. A left UVFP involves imaging from the base of skull to the mid chest (through the arch of the aorta). The right UVFP evaluation should extend from the base of the skull through the clavicle. Although CT is usually the test of choice, the decision between CT scanning and MRI is personal and can be decided by the otolaryngologist and radiologist.

• #6 Vocal Cord Paralysis | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/vocal-cord-paralysis/

  The Voice Center at UT Southwestern Medical Center offers exceptional expertise in diagnosing and treating vocal cord paralysis and other voice disorders. […] Our multidisciplinary team combines the expertise of fellowship-trained laryngologists (ear, nose, and throat specialists with specialized training in disorders of the larynx), speech-language pathologists with training specifically in voice care, and other care professionals with expertise in voice and throat conditions. Our team members are widely recognized as experts in the accurate diagnosis and effective treatment of vocal cord paralysis. […] Our voice care team at UT Southwestern includes fellowship-trained laryngologists and speech-language pathologists who conduct a thorough evaluation, which can include: […] Other tests we typically use include:

• #6 Vocal Cord Paralysis | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/vocal-cord-paralysis/

  Laryngoscopy: An exam using a narrow tube, either flexible or rigid, with a light and camera inserted through the nose […] Videostroboscopy: An exam using a telescope-like camera with a flashing light that provides a magnified, slow-motion view of the vocal cords as they vibrate […] Laryngeal electromyography (EMG): Small needles inserted through the skin into voice box muscles to measure their electric currents […] Sound (acoustic) analysis: Computer analysis that identifies abnormalities in the sounds produced by the vocal cords.

• #7 Bilateral Vocal Cord Paralysis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560852/

  The investigations that aid in diagnosis are as follows: Flexible fiberoptic laryngoscopy: Is an essential part of the initial physical examination and is performed with the patient awake in the office to assess spontaneous and volitional vocal cord movement. […] Direct laryngoscopy and bronchoscopy: If there is any question as to the status of the vocal cords or of the lower airway, this examination is indicated. This also allows palpation of the arytenoid joints to rule out fixation. […] Laryngeal electromyography: This is performed with the patient awake in the office to determine the innervation status of the laryngeal muscles, which can elucidate the duration of the paralysis and recovery potential after a neurologic injury. […] Imaging of the recurrent laryngeal nerve: In a patient with new-onset, idiopathic bilateral vocal cord paralysis, the entire course of the RLNs must be imaged to rule out a tumor or CNS pathology. […] There is no single lab test in bilateral vocal cord paralysis, and which investigations to consider will be guided by each patient’s history and overall medical picture.

• #7 Bilateral Vocal Cord Paralysis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560852/

  Vocal cord paralysis refers to the immobility of a vocal cord, which can be due to pathology of the vocal ford (also known as the vocal fold) itself, or of the verve that supplies the muscles creating vocal cord motion. […] This activity reviews the role of the interprofessional team in the evaluation and management of vocal cord paralysis. […] Describe the evaluation of bilateral vocal cord paralysis. […] Diagnosis is made clinically based on flexible fiberoptic laryngoscopy, where the vocal cords are observed to be immobile, and their position can be noted. If the diagnosis is still uncertain, video stroboscopy and bronchoscopy can provide additional information about the fluid-wave of the vocal cord vibrations and rule out subglottic and tracheal pathology, such as subglottic stenosis or tracheomalacia.

• #8 Vocal Cord Paralysis: Pathophysiology, Etiologies, and Evaluation

  https://www.ijhns.com/abstractArticleContentBrowse/IJHNS/27529/JPJ/fullText

  It is important to differentiate between nerve conduction block and presence of axonal injury for prognostication purposes when possible. […] Laryngeal electromyography (LEMG) is considered the gold standard investigation to diagnose and evaluate the type and degree of neurological injury in vocal cord paralysis. […] LEMG utilizes needle electrodes to record electrical activity from muscle fibres, including motor unit recruitment, configuration and detections of fibrillation or synkinesis, to estimate the severity of injury and prognosticate the likelihood of recovery, thereby providing additional information for clinicians to discuss management options with patients. […] In vocal cord paralysis due to lower motor neuron injury (e.g., surgical injury), initially there is complete electrical silence, followed by the appearance of positive sharp waves or fibrillations within 2-3 weeks, indicating denervation and axonal loss. […] Reinnervation is characterized by the recording of larger motor unit activity with characteristic high-amplitude, long-duration, and polyphasic responses. […] Reinnervation findings may occur after several months and are a positive prognostic indicator, especially in young patients.

• #9 Vocal Cord Paralysis Overview: Symptoms, Diagnosis, & Treatments | IFAR

  https://www.advancedreconstruction.com/head-neck/vocal-cord-paralysis

  Vocal cord paralysis is typically diagnosed by a doctor who specializes in ear, nose and throat disorders. The doctor will listen to your symptoms and voice quality and may also use an endoscope to look at your vocal folds. […] Your doctor may also perform a procedure called laryngeal electromyography, which measures the electrical impulses of the nerves in your larynx. […] During a laryngeal electromyography, a fine needle is inserted into the muscles around your larynx and your provider will ask you to make sounds or sniff to activate the nerves and muscles. This can help identify if you have paralysis and where.

• #10 Bilateral Vocal Fold Paralysis Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/863885-workup

  Features of the history and clinical findings may suggest performance of the following studies: […] Pulmonary function tests: Although diagnosis is based on clinical findings, results of pulmonary function tests performed with flow volume loops help support a diagnosis of upper airway obstruction. Also, they are used to provide an indicator of the severity of the obstruction and to monitor change after treatment. […] Fiberoptic laryngoscopy […] This procedure is the mainstay of clinical assessment. […] Laryngeal EMG […] In evaluating a patient with bilateral vocal fold immobility (BVFI), EMG provides the potentially useful information in the following: […] Laryngeal EMG can predict poor recovery 90% of the time.

• #11 Management of Pediatric Bilateral Vocal Fold Paralysis: A State-of-the-Art Review of Etiologies, Diagnosis, and Treatments

  https://www.mdpi.com/2227-9067/11/4/398

  Objective: This paper reviews the current literature about epidemiology, etiologies, diagnosis, and management of pediatric bilateral vocal fold paralysis (PBVFP). […] The diagnosis is based on the etiological features, clinical presentation, laryngoscopic findings, and objective examinations. Laryngeal electromyography may be used to support the diagnosis in difficult cases, but its reliability depends on the practitioner’s experience. […] The PBVCP diagnosis is mainly clinical, with nasofibroscopy revealing partial or total immobility of the vocal folds. […] The LEMG appears to be theoretically the best diagnostic tool because it may identify the nerve versus joint origin of the bilateral vocal fold immobility. […] In summation, the diagnosis of PBVCP may be currently based on the etiology of the child’s disorder(s), their clinical history, the flexible fiberoptic laryngoscopy findings, the assessment of comorbid tracheal or esophageal conditions, the findings reported through the suspension laryngoscopy, and the use of additional examinations for laryngeal function (LEMG) or for documenting the etiology of PBVCP.

• #12 Vocal cord paralysis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/vocal-cord-paralysis?lang=us

  Vocal cord paralysis/paresis (VCP), also known as vocal fold paralysis/paresis, refers to the impaired mobility of the true vocal cord or fold due to neurologic dysfunction. […] The diagnosis may also be made incidentally on laryngoscopy or imaging as up to one-third of patients with vocal cord impairment are asymptomatic. […] When vocal cord paralysis has been diagnosed, a cause should be actively sought along the course of the recurrent laryngeal nerve from origin in the brainstem, through the neck, and should always include the superior mediastinum.

• #13 Paralysis (Bilateral) | Sean Parker Institute for the Voice

  https://voice.weill.cornell.edu/voice-disorders/paralysis-bilateral

  Vocal fold paralysis is immobility of a vocal fold because of damage or dysfunction of its principal nerve. […] Vocal fold paralysis can be unilateral (one-sided) or bilateral (two-sided). […] Bilateral paralysis of the vocal folds usually happens for one of four reasons: nerve injury during a number of common surgeries, pressure on the nerves from a tumor growing next to them, stroke or other brain injury, or inflammation that stops the nerves from working (usually attributed to viral infection). […] The consensus is that a CT (or CAT) scan with contrast dye is the best way to examine the nerves in the neck and chest. Bilateral paralysis is more likely than unilateral paralysis to be related to stroke or other neurological disease, so a brain scan may be useful as well. […] A diagnosis of idiopathic vocal fold paralysis can only be made after all other possibilities have been eliminated.

• #13 Paralysis (Bilateral) | Sean Parker Institute for the Voice

  https://voice.weill.cornell.edu/voice-disorders/paralysis-bilateral

  Vocal fold paralysis is diagnosed by a lack of movement in both vocal folds. […] Initial (and sometimes, emergency) treatment of bilateral paralysis is aimed at making sure the airway will not be blocked. […] Some physicians have found electromyography (EMG) to be useful, both to diagnose paralysis and to help determine how likely it is that it will recover on its own. […] If the vocal folds do not recover motion, it is possible to continue indefinitely with a tracheostomy to ensure the airway is open.

• #14 Vocal Cord Paralysis Causes and Diagnoses | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/ent-ear-nose-throat/vocal-cord-paralysis/causes-and-diagnoses

  Diagnosing vocal cord paralysis […] Blood tests: Lab tests can identify if other conditions, such as Lyme disease or herpes viruses are involved […] Laryngeal electromyogram (EMG): This test can confirm nerve involvement and measure the severity of the damage to the nerves serving the larynx […] Laryngoscope: An endoscope (a thin, flexible tube with a light and camera on the end) is inserted into your throat to view the movement of your vocal cords […] Computed tomography (CT) scan: This test combines X-ray and computer technology to produce detailed cross-sectional images […] Magnetic resonance imaging (MRI) scan: This test creates detailed images using a large magnet, a computer and radiofrequencies. Unlike computed tomography (CT or CAT) scans or X-rays, MRI does not use radiation.

• #15 Vocal Cord Paralysis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vocal-cord-paralysis

  Vocal cord paralysis (also referred to as vocal fold paralysis by physicians) is a condition in which the vocal cords cannot move on one side (unilateral) or both sides (bilateral). This is usually happens when the nerve impulses to the vocal cords are interrupted. […] The diagnosis of vocal cord paralysis is usually made by laryngoscopy or stroboscopy, tests that examine the voice box. […] A laryngeal electromyography (EMG) may also be needed to evaluate the condition of the muscle of the vocal cords. An EMG can also help your childs doctors see if there is a healthy nerve signal to the vocal cords or if there is chronic loss of signal (denervation). […] Magnetic Resonance Imaging (MRI) of the brain, neck and chest may also be recommended if the cause of the vocal cord paralysis is not known.

• #16 Revisiting CT Signs of Unilateral Vocal Fold Paralysis: A Single, Blinded Study | American Journal of Neuroradiology

  http://www.ajnr.org/content/43/4/592

  Several CT findings are thought to be indicative of vocal cord paralysis; however, these signs have never been validated in a blinded fashion. […] This study attempts to compare and validate these signs and determine their accuracy in predicting vocal cord paralysis. […] The presence of medial displacement of the posterior ipsilateral vocal fold margin and ipsilateral laryngeal ventricular dilation yielded the greatest positive predictive value. […] Other signs demonstrated high specificity, but interrater discrepancy was greater than expected and diminished the reliability of these signs in predicting vocal cord paralysis. […] Overall, sensitivity and negative predictive values were low. […] Predicting vocal cord paralysis on the basis of CT findings is not as accurate or straightforward in prospectively predicting vocal cord paralysis as implied in prior studies.

• #16 Revisiting CT Signs of Unilateral Vocal Fold Paralysis: A Single, Blinded Study | American Journal of Neuroradiology

  http://www.ajnr.org/content/43/4/592

  Although laryngoscopic evaluation by an otolaryngologist remains the criterion standard to establish the definitive diagnosis of vocal cord paralysis, the presence of these signs noted incidentally on CT may cause the interpreting radiologist to question vocal cord paralysis in examinations ordered for other indications. […] This article tests the utility of these signs by blinding the interpreting radiologists to randomized CT scans of patients with and without UVFP. […] Our study demonstrates that it is much less straightforward to prospectively raise concern for UVFP compared with interpreting examinations when a laryngoscopic diagnosis of UVFP is confirmed. […] If medial displacement of the posterior ipsilateral vocal fold margin and ipsilateral laryngeal ventricular dilation are present, concern should be raised for UVFP prospectively and a thorough evaluation of the course of the vagus and recurrent laryngeal nerves from the skull base through the mediastinum should be performed on the available neck CT examination. […] It is not as accurate or straightforward to prospectively predict vocal cord paralysis based on CT findings as previously implied in prior studies. […] CT scan sensitivity and negative predictive value are low for vocal cord paralysis.

• #17 Vocal Cord Paralysis – Ear, Nose, and Throat Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/ear-nose-and-throat-disorders/laryngeal-disorders/vocal-cord-paralysis

  Vocal cord paralysis is the inability to move the muscles that control the vocal cords. […] The diagnosis is based on examination of the voice box (larynx), bronchial tubes, or esophagus. […] Doctors try to find the cause of the vocal cord paralysis. They ask questions about all possible causes, including chronic exposure to heavy metals (arsenic, lead, and mercury), use of the drugs phenytoin and vincristine, history of a connective tissue disorder (such as Marfan syndrome), Lyme disease, sarcoidosis, diabetes, and alcohol use disorder. […] In addition to asking questions about a person’s medical history, doctors base the diagnosis on laryngoscopy. Laryngoscopy is examination of the larynx, with a thin, flexible viewing tube.

• #18

  https://journals.lww.com/jolv/fulltext/2014/04010/laryngeal_ultrasound_in_diagnosis_of_vocal_cord.2.aspx

  Despite the prevalence of ultrasonography in medical practice, its use in laryngeal disorders appears underutilized. It provides a simple, easy, cheap and non-invasive method to diagnose vocal cord palsy in real time, dynamic 2 or 3-dimensional image mode. […] The present study evaluates the accuracy of ultrasonography in diagnosis of vocal cord palsy in 25 patients. […] We were able to accurately diagnose vocal cord palsy by ultrasound in all but two patients where the examination was limited by extensive laryngeal cartilage calcification. […] There is every evidence to suggest that ultrasonography has a place in diagnosis of vocal cord palsies. It is easy, cheap, available, and non-invasive. […] Laryngeal ultrasonography or Echolaryngography seems to be a simple, easy, cheap, non-invasive, easily available tool with no radiation exposure concerns.

• #18

  https://journals.lww.com/jolv/fulltext/2014/04010/laryngeal_ultrasound_in_diagnosis_of_vocal_cord.2.aspx

  Moreover, ultrasound imaging observes vocal cord movement in normal phonation with no need for the patient to stress. […] It can prove to be a useful and accurate diagnostic aid where fibreoptic laryngoscopy is limited by an uncooperative patient or one with sensitivity to topical xylocaine and where stroboscopy is not available.

• #19 Vocal Cord Dysfunction | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0115/p156.html/1000

  Vocal cord dysfunction involves inappropriate vocal cord motion that produces partial airway obstruction. […] The differential diagnosis includes asthma, angioedema, vocal cord tumors, and vocal cord paralysis. […] Pulmonary function testing with a flow-volume loop and flexible laryngoscopy are valuable diagnostic tests for confirming vocal cord dysfunction. […] The most valuable diagnostic tests for vocal cord dysfunction are pulmonary function testing with a flow-volume loop and flexible laryngoscopy. […] Flexible laryngoscopy is considered the diagnostic standard for vocal cord dysfunction. Direct observation of abnormal vocal cord movement toward the midline during inspiration or expiration confirms the diagnosis.

• #20 Voice Disorders

  https://www.asha.org/practice-portal/clinical-topics/voice-disorders/?srsltid=AfmBOopZy13G2tiiBeXt1K4V-y1XQ2YOoKpM3M-vcHeJn307UpddkKoY

  A voice disorder is present when an individual expresses concern about having an abnormal voice that does not meet daily needs even if others do not perceive it as different or deviant. […] Neurogenic organic voice disorders that result from problems with the central or peripheral nervous system innervation to the larynx that affect functioning of the vocal mechanism, such as vocal fold paralysis. […] Of individuals over the age of 60 years who had been evaluated for vocal problems, voice disorders were most commonly associated with presbyphonia, reflux/inflammation, functional dysphonia, vocal fold paralysis/paresis, and Reinkes edema. […] SLPs are trained to evaluate voice use and function to determine the cause of reported symptoms and select treatment methods for improving voice production.

• #21 Vocal Cord Paralysis: Symptoms, Diagnosis & Treatment Options | Suburban ENT

  https://subent.com/expertise/laryngology/vocalcords/

  There are more serious conditions such as cancer of the larynx, lung, thyroid, and esophagus that can also lead to vocal cord paralysis. This underscores the importance of having the correct diagnosis before initiating therapy. […] Treatment of the vocal cord paralysis depends on the cause and the patients overall condition. Often, speech and swallowing therapy provided by a speech and language pathologist is the only treatment necessary. Other times, surgical procedures can be offered than can dramatically improve the patients voice, swallowing, and overall quality of life. These procedures include: vocal cord injection, which can provide significant temporary relief, and medialization thyroplasty, which provides a more permanent rehabilitation to the paralyzed vocal cord. Your doctor at Suburban Ear, Nose, and Throat is uniquely trained to provide the voice restoration procedures for a paralyzed vocal cord.

• #22 Vocal Cord Paresis (Paralysis): Symptoms, Causes, and Treatment Options

  https://www.houstonent.com/blog/vocal-cord-paresis-paralysis-symptoms-causes-and-treatment-options

  Vocal cord paralysis can impact how you speak and breathe, resulting in vocal cord muscle paralysis. […] The Vocal Cord Paresis definition is: Paralysis of the vocal cords is a condition of your voice that can occur when one or both of your vocal cords don’t properly open or close. […] Although there are diagnostic technology advances, doctors can’t detect the cause if a lot of vocal cord paralysis cases. […] When this occurs, it’s called idiopathic (because of unknown origins). […] If your symptoms don’t completely recover by themselves, surgery could help enhance your ability to swallow and speak. […] After your initial evaluation, the doctor will likely refer you to an ENT doctor, or a doctor specializing in ear, nose and throat conditions.

• #23 Vocal Cord Paralysis: Pathophysiology, Etiologies, and Evaluation

  https://www.ijhns.com/abstractArticleContentBrowse/IJHNS/27529/JPJ/fullText

  Vocal fold paralysis often leads to significant morbidity including dysphonia, dysphagia and aspiration. […] An appropriate understanding of the pathophysiology, etiologies, and a systematic method of evaluation are essential for discussing prognosis and offering patients appropriate treatments. […] This article presents a discussion of the most recent literature surrounding vocal cord paralysis, specifically the pathophysiology and different etiologies, and proposes an evaluation strategy involving history, examination and targeted investigations. […] Damage or injury to these nerves may result in vocal fold paresis or paralysis. […] Vocal fold paralysis implies complete vocal fold immobility due to neurological injury. […] This article will discuss vocal cord paralysis. […] A brief overview of the RLN and SLN anatomy is presented, followed by a discussion of the pathophysiology, etiologies, and evaluation.

• #24 Vocal Cord Paralysis | IntechOpen

  https://www.intechopen.com/chapters/81705

  Laryngeal electromyography: This is an office procedure performed to determine the innervation status of the laryngeal muscles after a neurogenic injury. […] The aim of surgery in cases of unilateral cord paralysis is cord medialization. […] In bilateral cord paralysis, patient adequate airway must be re-established. […] Clinical data are limited for these new treatment options, and more interventional studies are needed. […] An integrated diagnostic and treatment program is necessary for patients with vocal cord paralysis.

• #24 Vocal Cord Paralysis | IntechOpen

  https://www.intechopen.com/chapters/81705

  Vocal cord paralysis can be due to neurogenic cause, trauma due to surgery, or mechanical fixation of the cords. Diagnosis of the underlying cause leading to paralysis of the vocal cords is important. […] Most commonly, there is paralysis of recurrent laryngeal nerve. […] It requires interprofessional team of otolaryngologists, radiologists, and speech therapists in the evaluation and management of vocal cord paralysis. […] Patients with unilateral cord paralysis present with a sudden onset of change in voice, that is, dysphonia and/or transient aphonia. […] Clinical diagnosis can be made based on flexible fiber-optic laryngoscopy, where the vocal cord position can be noted and are observed to be immobile. […] Flexible videolaryngoscopy: It is essential part of the initial physical examination and is performed with the patient awake in the office to assess vocal cord movement.

• #25 Vocal Fold Paralysis Causes, Diagnosis, Symptoms, & Treatment

  https://throatdisorder.com/voice-disorders/vocal-fold-paralysis/

  Vocal fold paralysis is a condition in which a vocal fold does not move. […] Diagnosis of vocal fold paralysis is made during laryngoscopy and stroboscopy. […] To evaluate for the cause of a vocal fold paralysis, a CT or MRI is used to examine the entire course of the nerve, from the skull to the chest. […] In cases in which vocal fold paralysis is potentially reversible, such as a when idiopathic, or when the nerve is inflamed (but not cut) after surgery, paralysis may resolve up to one year after injury. […] If the nerve is cut, or if a year has passed since injury and the vocal cord is not moving, permanent intervention is suggested.

• #26 Get Vocal Cord Paralysis Care | Cleveland Clinic

  https://my.clevelandclinic.org/services/vocal-cord-paralysis-treatment

  Its more common to have unilateral (one-sided) vocal cord paralysis as a result of some neck surgeries. This will usually affect your voice, but it can also make it hard to swallow and cause shortness of breath when youre trying to talk. Bilateral (two-sided) vocal cord paralysis is rare. It typically causes shortness of breath even when youre resting and especially with activity.

• #26 Get Vocal Cord Paralysis Care | Cleveland Clinic

  https://my.clevelandclinic.org/services/vocal-cord-paralysis-treatment

  Finding out whats wrong and starting treatment right away gives you a better chance of getting your vocal cords back in working order as soon as possible. […] At your appointment, well ask how youre feeling, what youre experiencing and your medical history. Well look at pictures of your throat and neck using imaging tests, such as a CT scan, X-ray or MRI. […] Getting a close look at your vocal cords is extremely helpful. To help see whats going on, your provider may do a laryngoscopy with stroboscopy. This procedure uses a thin tube with a camera on the end to take a closer look at your throat and vocal cords. Stroboscopy lets us to see how well your vocal cords vibrate and close. We may also do an electromyogram. This test lets us looks at how well your vocal fold nerves are working and the chances for recovery.

• #27 Bilateral Vocal Fold Paralysis | Atrium Health Wake Forest Baptist

  https://www.wakehealth.edu/condition/b/bilateral-vocal-fold-paralysis

  Bilateral vocal fold paralysis is a disorder characterized by complete immobility of both vocal folds. […] Symptoms of bilateral vocal fold paralysis are highly variable depending on the position of the paralyzed vocal folds. […] If the vocal folds are fixed in the paramedian (almost closed position), patients often have a normal voice, but may present with inspiratory stridor, and in some cases, respiratory failure due to airway obstruction. […] If the vocal folds are fixed in a more open position, the airway may be preserved, but the patient may experience a severely breathy, weak voice or complete voice loss.

• #28 Vocal Cord Paralysis | UCI Health | Orange County, CA

  https://www.ucihealth.org/medical-services/conditions/vocal-cord-paralysis

  Diagnosis of vocal cord paralysis occurs during a laryngoscopy and stroboscopy, which your physician uses an endoscope to evaluate the vocal cords. Often, a CT scan is ordered to determine the cause of the paralysis. […] Vocal cord paralysis treatment usually involves one of the following: […] A vocal cord injection is a procedure in which a filling agent such as collagen „bulks” the paralyzed vocal cord. […] Thyroplasty is a surgery that provides excellent long-term improvement of the voice. […] Laryngeal reinnervation is a surgery that was developed at UC Irvine. […] Treatment for vocal fold paralysis often also involves voice therapy with one of our speech and language pathologists.

• #29 Vocal Cord Paralysis: Symptoms, Causes, and Treatments

  https://www.healthline.com/health/vocal-cord-paralysis

  Vocal cord paralysis needs to be diagnosed and treated by a medical professional. Theres no at-home treatment for this condition that you should attempt before seeing a doctor. […] If voice therapy doesnt help, your doctor may recommend surgery. If both of your vocal cords are experiencing the paralysis, your doctor may recommend surgery right away. […] Sometimes vocal cord paralysis resolves on its own within a year. For this reason, a doctor may recommend voice therapy to try to restore nerve communication between your brain and your larynx before recommending surgery. […] After surgery, your voice may not sound better right away. Youll need to work with a speech-language pathologist after your surgery to develop a new way of speaking that accounts for changes in your vocal cords. […] Treating vocal cord paralysis doesnt always result in your vocal cords regaining their previous abilities. Since the causes of vocal cord paralysis involve nerve damage or progressive health conditions, correcting the paralysis itself may be difficult.

• #30 Vocal Fold Paresis | Sean Parker Institute for the Voice

  https://voice.weill.cornell.edu/voice-disorders/vocal-fold-paresis

  Laryngoscopic and Stroboscopic Signs in the Diagnosis of Vocal Fold Paresis […] Diagnosis of Vocal Fold Paresis: Current Opinion Practice […] The greatest challenge in the diagnosis of vocal fold paresis may be distinguishing it from insignificant asymmetries of motion of the two vocal folds. […] Some physicians have found a test known as electromyography (EMG) to be helpful in diagnosing paresis. […] However, there is debate about whether EMG is sensitive enough to correctly identify mild paresis, and/or if every mild abnormality identified by EMG signifies paresis.

• #31 Vocal Fold Paresis/Paralysis – THE VOICE FOUNDATION

  https://voicefoundation.org/health-science/voice-disorders/voice-disorders/vocal-fold-paresisparalysis/

  Partial (paresis) or complete loss (paralysis) of nerve function to voice box muscles results in abnormal vocal fold function, affects the ability to speak and sing and, in some cases, also breathe and swallow. Attempts to compensate for loss of muscle function, often leads to voice tiring after prolonged use (vocal fatigue). […] Interruption of the nerve input to voice box muscles may be temporary or permanent, partial or complete, and may affect one or more voice box muscles. […] Absence of vocal fold movement (vocal fold immobility) is highly suggestive of vocal fold paralysis but may also be due to other causes hence thorough medical evaluation is necessary. […] Likewise, if the vocal folds do move, it does not eliminate nerve impairment as a cause of the voice disorder since vocal fold paresis may be present.

• #32 Common Questions about Vocal Fold Paralysis – Department of Surgery

  https://www.surgery.wisc.edu/2019/04/19/common-questions-about-vocal-fold-paralysis/

  Learn about diagnosis, treatment, and research of vocal fold paralysis. […] When the diagnosis is not clear, laryngeal EMG can be helpful to differentiate the cause of the vocal fold immobility and, in some cases, help determine whether vocal fold mobility is likely to return. […] These operations are considered permanent fixes for the unilateral vocal fold paralysis; thus, we tend to wait between 6 to 12 months before we recommend them. […] Classically, vocal fold paralysis results in glottal incompetence reduced laryngeal valving ability due to an impaired ability of the vocal folds to meet at midline. […] Importantly, vocal fold paralysis has been shown to have a substantial impact on quality-of-life and new tools are being developed to measure this impact. […] As vocal fold paralysis is a neuromuscular disorder, it cannot be reversed by voice therapy. Nevertheless, voice therapy often plays an important role in the management of voice difficulties due to paralysis.

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