CHENNAI : If the vocal cords of a person are not healthy, he/she might face problems in speaking. Not just that, a person can also experience struggle in breathing as human vocal cords are responsible not just for the production of sound used for speech but also for regulating the flow of air into our lungs. The vocal cords also protect the airway from choking on any material in the throat by preventing food, drink, and even the saliva from entering the windpipe (trachea). Vocal cords are the folds of tissue located in the larynx (voice box). For some people, their vocal cords can be paralysed which can lead to several difficulties in living a normal life.
To put it in another way, vocal cords are two flexible bands of muscle tissue that are situated at the entrance to the windpipe (trachea). When one speaks, the bands come together and vibrate to produce a sound. The remaining time, the vocal cords are relaxed in an open position to allow breathing.
When the muscles that control the vocal cords are unable to move, it leads to vocal cord paralysis. This usually happens when the nerve impulses in the larynx are ruptured which results in the paralysis of the muscles of the vocal cord.
In majority of the cases of vocal cord paralysis, only one vocal cord is paralysed. Both the vocal cords being paralysed is a rare but serious condition which can cause vocal difficulties and significant problems with breathing as well as swallowing. Vocal cord paralysis can occur due to tumours and certain cancers, or because of nerve damage that can happen during surgery or sometimes even as a result of viral infections. Some possible causesn The most common surgeries that have a risk of damaging the vocal cord are thyroid or parathyroid glands surgeries, or the surgeries of esophagus, neck, and chest.
n Any major trauma or a serious injury to the chest or neck can also prove harmful for the vocal cords or the voice box even without the surgery.n A heart stroke can also be a cause as it interferes with blood flow in the brain and can damage the part which is responsible for sending messages to the voice box.
n Tumours, both cancerous as well as non-cancerous, tend to grow in or around the muscles, cartilage or the nerves that control the function of your voice box and hence lead to vocal cord paralysis.n Certain infections like Epstein-Barr virus, Lyme disease and herpes can also lead to inflammation and directly damage the nerves in the larynx.n If a person has some neurological conditions like multiplesclerosis or Parkinson’s disease, he/she might also experience vocal cord paralysis.
Risk factors
n Those who are undergoing chest or throat surgery must be careful. People who require a surgery on their thyroid, throat or upper chest are more exposed to the risk of damage to the nerves of the vocal cord. At times, breathing tubes are used either in surgery or to help the patient breathe if they are having serious respiratory trouble which can damage the vocal cord nerves.
n People with some neurological medical conditions are also prone to developing vocal cord weakness or paralysis. If an unidentified, persistent hoarseness is experienced in the throat constantly for over two weeks, or if any unexplained voice changes or discomfort are observed, it is advised to get it medically examined and contact the doctor. Treatments for vocal cord paralysis are available and usually involve surgery, and sometimes voice therapy.
Signs and symptoms of vocal cord paralysis
n A breathy trait observed in the voice
n Noisy breathing
n Hoarseness
n Losing the vocal pitch
n Possible choking or
coughing while swallowing food, drink or saliva
n The urgency to take frequent breaths while speaking
n Not being able to speak loudly
n Loss of the gag reflex
n Ineffective coughing
n Need to constantly and frequently clear the throat
—The author is consultant-ENT and cochlear implant surgeon, Aster RV Hospital, Bengaluru