Recurrent paresis (ICD-10 G52.2: diseases of the vagus nerve; J38.0: paralysis of the vocal folds and larynx) is a vocal cord paralysis. In this case, the laryngeal recurrent nerve is damaged. This nerve is a branch of the vagus nerve, the fourth cranial nerve. The failure of the nerve causes paresis (paralysis) of the internal muscles of the larynx.
Recurrent paresis can be unilateral or bilateral.
Recurrent paresis can be caused by surgery. For example, it is a typical complication of thyroid surgery. The nerve can be damaged unintentionally during surgery of benign (benign) thyroid diseases (prevalence (disease frequency): 0.1-0.6%). In the course of surgery for malignant (malignant) thyroid tumors, the lesion of the recurrent laryngeal nerve must occasionally be accepted in the interest of the healing intention. Also, recurrent nerve palsy is one of the possible postoperative complications of thyroidectomy (surgical removal of the entire thyroid gland) (prevalence: 1-3%).
Course and prognosis: Since in bilateral recurrent paresis the immobile vocal cords are as close together as they normally are during phonation (voice production), the voice usually sounds better than in unilateral recurrent paresis, whose typical symptom is dysphonia (hoarseness). However, the glottis is narrow during respiration (inhalation), so breathing problems are a major problem in bilateral recurrent paresis, especially during physical exertion.
Once the recurrent laryngeal nerve is severed, recurrent paresis occurs with permanent (persistent) dysphonia that is not reversible. As long as the nerve is “only” bruised or overstretched, the loss of function is reversible.
