Synonyms
vocal cord paralysis, vocal fold paralysis, dysphonia
Definition
Recurrent paresis (vocal cord or vocal fold paralysis) refers to the weakness or failure of the laryngeal muscles and vocal cords due to damage to the vocal cord nerve (laryngeal nerve). The term is composed of the name of the nerve (laryngeal recurrent nerve) that is damaged and the Greek term for paralysis (paresis). The vocal folds or vocal cords belong to the voice-forming apparatus of the larynx.
It is composed of: The laryngeal recurrent nerve gives instructions for movement to the inner laryngeal muscles, which is important for voice formation. The laryngeal recurrens nerve has its name because of its special anatomical course, since it first leaves the neck area up to the thorax, but then turns around and returns to the larynx (from Latin: recurrere). During voice formation (phonation), the vocal chords, which are appropriately prestressed by the laryngeal muscles, are blown from the lungs, set into vibration and thus produce the voice of each individual.
If one of these nerves fails, the vocal chords can no longer be adequately prestressed and thus cannot be brought into proper vibration. If this occurs, typical symptoms of recurrent paresis can occur. These are caused by the fact that the vocal chords must come within a few millimeters of each other for a perfect voice, but at the same time they must also be as far apart as possible during breathing so that air can be breathed in and out undisturbed. These two important functions are disturbed in recurrent paresis.
- A left and
- A right vocal cord.
Symptoms
With regard to the symptoms of recurrent paresis, a distinction must be made between unilateral and bilateral recurrent paresis, depending on whether only one or both vocal cords fail due to nerve damage. In unilateral recurrent nerve palsy due to the failure of the vocal nerve on this side, the vocal cord on the affected side is in the so-called paramedian position. This means that the mobility of this vocal cord is restricted.
This malposition can cause moderately pronounced hoarseness and a loss of volume in the voice of the affected patient. Patients often also lose the ability to shout or sing. In the case of bilateral recurrent paresis, i.e. a failure of the entire laryngeal muscles, the symptoms are more severe.
Among other things, patients complain about over-sensitivity: Breathlessness is caused by the fact that both vocal folds are in the so-called paramedian position, thus reducing the window for incoming and outgoing air to such an extent that breathing difficulties can occur. In addition, the narrow position of the vocal cords makes it difficult to remove mucus from the bronchial tubes and lungs, so that viral and bacterial infections can occur more frequently.
- Shortness of breath,
- Severe hoarseness and
- Stridor, which means a strong hissing or whistling sound when breathing.
