VOCAL FOLD IMMOBILITY

VOCAL FOLD IMMOBILITY

Unilateral or bilateral vocal fold (cord) paresis and paralysis may be congenital, or more commonly may result from injury to the recurrent laryngeal nerves.

CLINICAL FEATURES -  Patients may present with varying degrees of hoarseness, dysphagia, or high-pitched stridor.

 If partial function is preserved (paresis), the adductor muscles tend to move better than the abductors, with a resultant high-pitched inspiratory stridor and normal voice.

RISK FACTORS-  for acquired paresis/paralysis include difficult delivery (especially face presentation), neck and thoracic surgery (e.g., ductal ligation or repair of tracheoesophageal fistula), trauma, mediastinal masses, and central nervous system disease (e.g. Arnold Chiari malformation).

Unilateral cord paralysis is more likely to occur on the left because of the longer course of the left recurrent laryngeal nerve and its proximity to major thoracic structures.

 Bilateral cord paralysis, the closer to midline the cords are positioned, the greater the airway obstruction; the more lateral the cords are positioned, the greater the tendency to aspirate and experience hoarseness or aphonia Airway intervention (tracheostomy) is rarely indicated in unilateral paralysis but is often necessary for bilateral paralysis.

DIAGNOSIS-  Clinically, paralysis can be assessed by direct visualization of vocal fold function with laryngoscopy or more invasively by recording the electrical activity of the muscles (electromyography). Electromyogram recordings can differentiate vocal fold paralysis from arytenoid dislocation, which has prognostic value.

 Recovery is related to the severity of nerve injury and the potential for healing.

Many homoeopathic medicine have been found useful in this conditions.