Vocal Fold Paralysis | OSU Wexner Medical Center

Author: Ohio State Wexner Medical Center

One of the more common disorders that I see patients for is vocal fold paralysis where one of the one or both of the vocal folds are not moving properly. This can significantly impact someone's voice, or their airway or their swallowing. Most commonly they have trouble with their voice, but the vocal folds are really the gateway to our airway and they help protect our airway when we swallow. And so if one of the vocal folds is not moving properly then you may have problems in any of these three areas. When we assess a patient with vocal fold paralysis we want to know what may have caused it. Some of the more common reasons for why someone has a vocal fold paralysis may be due to injury such as a trauma to the neck or or trauma to the brain where the nerve communicates to the larynx and it's not working properly.

Other reasons are an illness such as an upper respiratory illness can sometimes cause a viral injury to the how the nerve communicates to the vocal fold and how it allows it to move. Sometimes cancers can invade the nerve that goes to the vocal fold and cause a weakness in that muscle as well. So if someone has a vocal fold paralysis we want to figure out what what may be the cause of this. Patients may have had surgery in their neck or chest and may have a an injury to the nerve that goes to the vocal fold. So we want to identify that too if someone had surgery previously or an intubation injury that may have caused the vocal fold paralysis. This is something that can be assessed at any time.

Just because someone may have injured their voice you know, many months or years ago, it doesn't mean that we can't do something now about it. Most commonly, we see patients within a few weeks to a few months of an injury to the voice where they have a vocal fold paralysis. Oftentimes we'll see a patient that's suffered a stroke and sometimes that's several weeks from when they actually had the stroke. They've gone through rehabilitation or been in a a nursing facility for quite some time but their voice hasn't returned completely or they still have swallowing dysfunction. This may be several weeks or months and that's okay.

We can often still help them if they come in to see us. We identify the problem in terms of the vocal fold paralysis and then we can determine whether there's treatment options that are viable for them including additional speech pathology to work on their swallowing or voice function or we can consider some other interventions such as vocal fold augmentation. Sometimes we do an augmentation procedure in the in the operating room where we put an implant into the vocal fold to move the vocal fold into a better position so that the opposite vocal fold that is moving can then contact it and help create a more robust and and strong voice for the patient. And this is something that patients do very well with but it requires selecting the right patient and understanding what may have caused the vocal fold paralysis in the first place.

Vocal Fold Paralysis | OSU Wexner Medical Center

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