Vocal cord palsy

Vocal cord paresis, also known as vocal cord paralysis is a condition in which one or both vocal cords are unable to move. Vocal cord paralysis is not a diagnosis but a sign of disease.

In unilateral vocal cord paralysis, one side is paralyzed. The paralyzed vocal cord does not move to vibrate with the other cord but vibrates abnormally or does not vibrate at all. The individual will be unable to speak clearly or loudly. In bilateral vocal fold palsy, both vocal cords get stuck halfway between open and closed and cannot move either way.

The causes of voice cord palsy may be a lesion anywhere from the cerebral cortex to the neuromuscular junction. Small lesions in the nucleus ambiguous may produce isolated laryngeal and pharyngeal motor losses which are leading cause of bilateral vocal cord palsy. Infants with stridor often have congenital paralysis of vocal cords with or without other associated abnormalities. The other causes of paresis include viral infection, vocal cord tumor, trauma, compression of the recurrent laryngeal nerve from intubation, or laryngopharyngeal reflux. Cardiac surgery is a risk to normal voice function as the nerves serving the larynx are positioned near the heart. Symptoms of paresis include hoarseness, vocal fatigue, mild to severe reduction in vocal volume, pain in the throat when speaking, shortness of breath; choking or coughing while eating, possible pneumonia due to aspirated food and liquid in the lungs. Unilateral paralysis can be treated medically and/or behaviorally. Medical treatment includes muscle-nerve transplant, medialization thyroplasty (moving the paralyzed vocal cord toward midline), or injection of a substance to increase the size of the paralyzed vocal cord. The palsy condition often requires a tracheotomy to protect the airway during eating.

Vocal cord nodules

Vocal fold nodules are small, inflammatory or fibrous growth that is formed on the vocal cords of people who constantly strain their voices. They are mostly seen on positions where contact is most forceful. Nodules on vocal cords reduce or obstruct the ability of the vocal folds to create the rapid changes in air pressure which is required to generate human speech. Vocal cord nodules are benign growths on both vocal cords that are caused by the repeated abuse of the vocal cords which results in soft, swollen spots. These spots eventually develop into harder, callous-like growths called nodules. The size and stiffness of nodules increases as the vocal abuse continues. They appear typically at the midpoint, and directly face each other. When overuse of the area is stopped these lesions often disappear.

Nodules and polyps cause similar symptoms that include: hoarseness, breathiness, harshness, shooting pain from ear to ear, a foreign body sensation in throat, neck pain, and decreased pitch range, voice and body fatigue.
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