Vocal Fold Paralysis

Paresis/paralysis can happen at any age, from birth to advanced age, in males and females, from a variety of causes. The effect on patients could vary greatly, depending on the patient’s use of his or her voice.

Vocal Fold Paralysis is the total interruption of nerve impulse, resulting in no vocal fold movement.

Vocal Fold Paresis is the partial interruption of nerve impulse, resulting in weak or abnormal motion of laryngeal muscles.

Etiologies

Sno.	Adults	Children
1.	Damage or trauma to the recurrent laryngeal nerve and superior laryngeal nerve during surgery	Birth trauma
2.	Can regenerate and re-establish movement	Neurological Disorders Arnold-Chiari malformation Hydrocephalus Cerebral Palsy Hypoxia Cardiac surgery
3.	Can be due to neurological conditions, viral infections, head/neck injuries, tumors, disease, surgery, stroke	Tracheosophageal fistula has been associated in 12% of children with vocal fold paralysos (Syed, 2014)

Sno.

Adults

Children

Damage or trauma to the recurrent laryngeal nerve and superior laryngeal nerve during surgery

Birth trauma

Can regenerate and re-establish movement

Neurological Disorders

Arnold-Chiari malformation
Hydrocephalus
Cerebral Palsy
Hypoxia
Cardiac surgery

Can be due to neurological conditions, viral infections, head/neck injuries, tumors, disease, surgery, stroke

Tracheosophageal fistula has been associated in 12% of children with vocal fold paralysos (Syed, 2014)

An individual with Vocal Fold Paralysis would be seen by an Otolaryngologist (ENT). The ENT will be able to diagnose vocal fold paralysis.

Therapies I would recommend:

Half Swallow, Boom: When the patient swallows, the larynx is at maximum closure as physiologically possible. “Boom” is a brief word composed of voiced sounds that can all be produced as the air is released from the constricted larynx. There is then back pressure on the larynx (like blowing through a straw). Head turning assists with laryngeal closure

Resonance Treatment: The patient’s increased awareness of easy onset helps facilitate a more appropriate manner of phonation.

Pushing Approach: Helpful for patients with traumatic injury to the vocal folds, unilateral vocal cord paralysis, generalized fatigue. Increases strength in vocal fold adduction

– Angie