Highlights

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Key Glossary Terms

Paresis
Partial paralysis; partial loss of nerve function resulting in partial loss of muscle function

Paralysis
Complete loss or absence of nerve function resulting in complete loss of muscle function

LEMG or Laryngeal Electromyography
Test that measures electrical signals of nerve inputs to muscles

RLN or Recurrent Laryngeal Nerve
Branch of vagus nerve to voice box muscles that open and close vocal folds

SLN or Superior Laryngeal Nerve
Branch of vagus nerve to cricothyroid muscle involved in control of pitch

Glossary

Related Experiences

52 year old male describes:

• Symptoms of vocal fold paralysis after neck surgery (204K)

Personal Experiences

Partial (paresis) or complete loss (paralysis) of nerve function to voice box muscles results in abnormal vocal fold function, which affects the ability to speak and sing, and in some cases also affect breathing and swallowing functions. Attempts to compensate, oftentimes leads to voice tiring after prolonged use or vocal fatigue.

Interruption of the nerve input to voice box muscles may be temporary or permanent, partial or complete, affecting one or more voice box muscles.

Vocal fold paresis and paralysis comprise a range - from mild to severe - of abnormal voice box muscle functions due to varying degrees of abnormal nerve input.

Paresis of voice box muscles is oftentimes missed as the cause of a voice disorder because patient complaints can be very mild. For example, a patient with vocal fold paresis may only notice voice tiring after use, oftentimes at the end of the day (vocal fatigue).

• Absence of vocal fold movement or 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.

• Magnified viewing of vocal movement and position through a special scope or laryngoscopy can identify vocal fold abnormalities suggestive of vocal fold paralysis. (For more information, see Laryngoscopy/Stroboscopy.)
• Laryngeal electromyography or LEMG confirms the diagnosis of vocal fold paralysis and vocal fold paresis. (For more information, see LEMG.)

Since there are many causes of vocal fold paresis and paralysis, the cause for each patient needs to be evaluated systematically. As with all disorders, finding out the cause helps map out a treatment plan.

Even when nothing can be done about the nerve damage causing vocal fold paresis or paralysis, improving the function of the vocal fold and voice can be addressed by the voice box surgeon-specialist (laryngologist).

Red Flag

Any and all airway problems require immediate attention.