Do you sometimes feel like your voice is very hoarse, or that it changes when you speak, as if you have a cold? Maybe you feel like you have a sore throat even after drinking a little water, or you suddenly feel like you are short of breath when you talk. These are not just symptoms of a cold, but maybe the cause behind this is a condition called Vocal Cord Paralysis, which we are going to talk about today. Don't worry, let's talk about this simply.
What is Vocal Cord Paralysis?
Simply put, vocal cord dysfunction is when one or both of the vocal cords in your throat that produce your voice are not working properly. Think of them as the strings of a guitar. But they are located in a small box in your throat called the larynx . The larynx is located above your windpipe (trachea) .
When we breathe, these two vocal cords move apart, allowing air to pass into the lungs. When we swallow food or drink, these two muscles close tightly, or food or drink can get stuck in the windpipe. When we speak or sing, these vocal cords come together and vibrate as air from the lungs vibrates, creating sound.
So, what happens in vocal cord dysfunction is that when the nerves that control these vocal cords are damaged , those muscles don't open or close properly. Then it can be difficult to speak, swallow, and sometimes even breathe. Got it?
What are the types of vocal cord dysfunction?
There are mainly two types:
1. Unilateral vocal cord paralysis: This is when only one vocal cord is paralyzed. When one side is not working, there may be a change in the voice, and some people may have difficulty swallowing. However, there is usually no major difficulty in breathing.
2. Bilateral vocal cord paralysis: Here, both vocal cords are paralyzed. This is a serious condition. Because when both vocal cords are paralyzed, they often stop close together. Then the airway becomes blocked, causing severe breathing difficulties. This can be life-threatening.
Remember, unilateral dysfunction is the most common. It is rare for both vocal cords to be dysfunctional. However, both types can develop at any age.
How serious can this situation be?
In unilateral paralysis, symptoms can range from mild to severe. For example, some people may have difficulty speaking. In more severe cases, they may experience shortness of breath while talking. They may also experience coughing and sore throat when eating or drinking.
In bilateral dysfunction, the vocal cords become close together and block the airway, making breathing very difficult. It also causes difficulty swallowing. If food or drink enters the airway and enters the lungs, a dangerous condition called aspiration pneumonia can occur.
If you have difficulty breathing or swallowing, see a doctor immediately.
What are the symptoms of vocal cord dysfunction?
Symptoms depend on the extent of dysfunction and how the vocal cords are positioned relative to each other.
These are the common symptoms:
- Voice becomes hoarse, weak, scratchy, or windy .
- Changes in the pitch of the voice.
- Changes in the volume of the voice.
- Difficulty breathing (Dyspnea) or loss of voice.
- Making a noise while breathing (e.g., like a whistling sound).
- Difficulty swallowing (Dysphagia).
- Inability to clear the throat from a cough.
- Throat tightness when trying to swallow.
What does a dead vocal cord feel like?
You may not feel any sensation directly from your vocal cords. Instead, you may feel symptoms caused by your dysfunctional vocal cords. You may feel a great deal of strain and fatigue when trying to get more air into your lungs or to make your voice sound the way you want. You may feel like your throat is getting blocked if food or drink gets stuck in your windpipe. Some people feel like their throat is constantly full of mucus and can't clear it.
Is it possible to speak with vocal cord dysfunction?
Most people can speak, but it takes a lot of effort. You will notice changes in your voice. You may become hoarse when speaking. If the dysfunction is severe, you may even lose your voice completely.
What are the causes of vocal cord dysfunction?
There are several reasons why the nerves that control the movement of the vocal cords can be damaged:
- Autoimmune diseases: Diseases that interfere with communication between nerves and muscles, for example , Myasthenia Gravis (MG) .
- Infections: Infections such as Lyme disease, herpes, Epstein-Barr virus, and COVID-19 can cause swelling and damage to the nerves that control the vocal cords.
- Injury: Injuries to the neck, head, and chest area can cause nerve damage.
- Neurological diseases: Diseases associated with nerve destruction or damage, such as multiple sclerosis (MS) , Parkinson's disease , and stroke .
- Poisonous substances: Poisonous substances such as lead, mercury, and arsenic can damage nerve tissue.
- Surgery: Head and neck surgeries, such as thyroidectomy , parathyroid surgery, heart surgery, and cervical spine surgery, can cause nerve damage as a complication. The use of a breathing tube during surgery can also sometimes damage the nerves in the larynx.
- Tumors: Both malignant and benign tumors can press on the nerves in the larynx, causing damage. Both thyroid cancer and thyroid nodules can damage these nerves.
Sometimes, a vocal cord dysfunction can occur after a cold or upper respiratory infection. Doctors may not always be able to find a specific cause. Such cases are called idiopathic or post-viral vocal cord dysfunction.
How do doctors diagnose vocal cord dysfunction?
Otolaryngologists, specifically laryngologists, are the doctors who diagnose and treat this condition. First, they will ask you about your symptoms and your medical history. To confirm the diagnosis, your doctor may order tests such as:
- Imaging studies: MRI or CT scans can take detailed pictures of the brain, throat, vocal cords, larynx, thyroid gland, and chest. These can help detect things like tumors that could be damaging the nerves in the larynx. You may also be asked to take an X-ray of your esophagus or chest.
- Laryngoscopy: This allows doctors to look directly at the larynx and vocal cords. The doctor inserts a long, thin tube called a laryngoscope through the nose and down the throat. This flexible tube has a camera on the end that takes pictures of the larynx and vocal cords. The pictures are shown on a monitor for the doctor to view.
- Videostroboscopy: This allows doctors to see how your vocal cords vibrate and how close they are to each other when you speak. This procedure is similar to a laryngoscopy. Often, the two are done together. Videostroboscopy uses a special camera to show how your vocal cords move slowly as you make sounds. This helps the doctor find any problems.
- Laryngeal electromyography (LEMG): This test measures how the muscles of the larynx are controlled by nerves. The electrical impulses from these muscles are measured and recorded.
- Blood tests: If your doctor suspects that your vocal cord dysfunction is caused by an infection or autoimmune disease, he or she will order blood tests.
How is vocal cord dysfunction treated?
Treatment depends on the severity of the dysfunction and your symptoms. If the dysfunction is mild, you may need voice therapy to improve the function of your vocal cords. In this therapy, you do special exercises that strengthen your vocal cords, teach you how to control the muscles that help you speak, and improve the way you breathe while speaking.
More severe vocal cord dysfunction may require surgery.
Treatment for unilateral vocal cord dysfunction
In cases of unilateral dysfunction, doctors often wait until the condition improves and postpone surgery for about a year. Sometimes the vocal cords may be bruised or strained, and it takes time for them to heal. This can take months. Voice therapy with a speech-language pathologist can sometimes be very effective, helping to strengthen the voice if the problem is mild to moderate.
A laryngologist may recommend surgery or vocal fold injections to improve voice, swallowing, and breathing difficulties. Options include:
- Vocal cord injection: The doctor injects a filler through a needle. There are several types of safe fillers. This filler closes the gap between the vocal cords.
- Voice box implant (Laryngeal framework surgery): The doctor inserts a framework into your larynx. Most frameworks are made of silicone. This framework holds the vocal cords in place and helps close both vocal cords. These procedures include a procedure called medialization laryngoplasty (Thyroplasty) .
- Reinnervation surgery: The doctor takes a nerve that connects to other muscles in your neck and reconnects it to the nerve that moves your vocal cords. This procedure does not affect the other muscles in your neck.
Treatment for bilateral vocal cord dysfunction
People with both vocal cords failing can have dangerously narrowed airways. They may need a tracheostomy (a breathing tube placed in the neck) to open the airway and help them breathe.
In this surgery, a doctor makes an incision in your neck and inserts a tube into your throat. The tube opens your airway and helps you breathe. Sometimes, the doctor uses a laser to remove part of the back of one or both vocal cords, widening the airway so you can breathe more easily. If you have a tracheostomy, another option that can help you breathe longer is a tube-free tracheostomy.
Can a dysfunctional vocal cord be restored?
Sometimes the vocal cords will heal on their own. This can take months. With voice therapy, vocal cord injections, or implants, your voice can be strengthened and others can hear you better when you speak. You may also find that your swallowing and breathing improve with treatment. Ask your doctor how much of your vocal cord function you can regain with treatment.
Can vocal cord dysfunction be prevented?
Vocal cord dysfunction cannot always be prevented. Talk to your doctor if you have a medical condition that increases your risk. They may recommend regular checkups to check your vocal cords. You may also need voice therapy to improve the function of your vocal cords.
What is the outlook for people with vocal cord dysfunction?
Most vocal cord dysfunctions can heal on their own over time. Speech therapy and possibly filler injections can help improve symptoms while your vocal cords heal. If your vocal cord dysfunction is permanent, an implant to hold the vocal cord in place is the best treatment. Rarely, if the implant moves out of place, your doctor may need to reposition it.
With treatment, most people regain the ability to speak and swallow after vocal cord dysfunction. Your recovery rate will depend on several factors, including whether the dysfunction is in one or both vocal cords, and whether it is mild or severe.
When should I see a doctor about vocal cord dysfunction?
If you have symptoms of vocal cord dysfunction, talk to a doctor. Changes in your voice, unexplained hoarseness, a wheezing sound when breathing, shortness of breath when speaking, or coughing and sore throat when eating or drinking are not uncommon. Getting treatment early can help prevent your condition from getting worse. In some cases, non-invasive treatments, such as voice therapy, can help you avoid surgery.
When should I go to the Emergency Department (ETU) ?
If you have trouble breathing or swallowing, seek immediate medical attention. Not getting enough air is a sign of bilateral vocal cord dysfunction, which is the most severe form of the condition. Because the vocal cords don't close properly, food and drink can enter the airway, causing aspiration pneumonia , which can be fatal if left untreated.
Take-Home Message
If you have symptoms such as a distinct change in your voice, hoarseness, difficulty breathing while speaking, difficulty swallowing, or frequent regurgitation of food and drink, don't just ignore it. These could be signs of vocal cord paralysis .
The most important thing to remember:
* If you have severe difficulty breathing or difficulty swallowing, go to a hospital immediately.
* If you have other symptoms, see an ear, nose, and throat (ENT) specialist immediately.
* If diagnosed and treated early, this condition can often be managed well, and may even be completely cured.
There's no need to panic, but it's important to be aware of these symptoms. Talk to your doctor and get the necessary tests and treatment.
` Voice changes, vocal cord dysfunction, hoarse voice, difficulty swallowing, difficulty breathing, Vocal Cord Paralysis, Laryngoscopy, voice therapy
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න