Vocal fold paresis

Vocal fold paresis is a medical condition characterized by the partial loss of movement or weakened movement of one or both vocal folds. This condition can significantly impact an individual's ability to speak and, in some cases, to breathe and swallow. Vocal fold paresis is considered less severe than vocal fold paralysis, where there is a total loss of movement in the affected vocal fold(s).

Causes

Vocal fold paresis can result from various causes, including nerve damage or disruption. The primary nerve involved in vocal fold movement is the recurrent laryngeal nerve, which can be damaged due to surgical procedures (such as thyroidectomy), viral infections, neurological disorders, or trauma to the neck. Another nerve that can be affected is the superior laryngeal nerve, though its impairment typically affects the voice's pitch rather than causing paresis.

Symptoms

The symptoms of vocal fold paresis can vary depending on the severity and whether one or both vocal folds are affected. Common symptoms include:

• Hoarseness or a breathy voice
• Reduced vocal endurance
• Difficulty projecting the voice
• Changes in vocal pitch
• A sensation of choking or aspiration, especially when swallowing liquids

Diagnosis

Diagnosis of vocal fold paresis involves a comprehensive evaluation by an otolaryngologist (ENT specialist) or a speech-language pathologist. Tools and procedures used in diagnosis may include:

• Laryngoscopy or stroboscopy to visually examine the vocal folds' movement
• Electromyography (EMG) to assess the electrical activity of the laryngeal muscles
• Voice assessment tests to evaluate the functional impact on the voice

Treatment

Treatment for vocal fold paresis aims to improve vocal function and may include:

• Voice therapy with a speech-language pathologist to optimize vocal fold closure and improve voice quality
• Surgical interventions, such as vocal fold injection (injection laryngoplasty) to bulk up the paralyzed vocal fold, or thyroplasty to reposition the affected vocal fold
• In some cases, treatment may also focus on managing underlying conditions contributing to the paresis

Prognosis

The prognosis for vocal fold paresis varies depending on the cause and severity of the condition. Some individuals may experience significant improvement or complete recovery, especially with early intervention and appropriate treatment. However, others may have persistent symptoms that require ongoing management.

See Also

• Vocal fold paralysis
• Voice therapy
• Laryngoscopy
• Electromyography

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