Vocal cord paralysis Flashcards
syx of Vocal cord paralysis 10
breathy quality to voice
hoarness
noisy breahting
SOB
loss of vocal pitch
choking or coughing while swallowing food drink or saliva
need frequent breaths when speaking
inability to speak loudly
loss of gag refelx
ineffective cough
causes of Vocal cord paralysis 6
injruy to vocal cord during surgery
neck or chest injury -trauma
stroke- can damage brain
tumours
infections- lyme disease, EBV
neuro conditions
-MS, parkinosns
what is the primary innervation to the vocal cords
branches of teh vagus nerve
diagnosis of Vocal cord paralysis 2
laryngoscopy
laryngeal electromyography
-measures electtic curents in your voice box msucesl
blood tests and scans
-standard bloods, Xray MRI CT
management of Vocal cord paralysis 2
voice therapy
-excersiss or other acititvitts to strengthen vocal cors
surgery
-bulk infection
-structural implants
-vocal cord repositioning
-replacing damaged nerve
-trachetomy
management of Vocal cord paralysis 2
voice therapy
-excersiss or other acititvitts to strengthen vocal cors
surgery
-bulk infection
-structural implants
-vocal cord repositioning
-replacing damaged nerve
-trachetomy
state the two types of Vocal cord paralysis
unilateral
bilateral
what are the causes of unilateral Vocal cord paralysis
most common
1/3- neoplastic origin
1/3 traumatic
1/3 idiopathic
causes of bilateral Vocal cord paralysis 4
LIFE THREATENING
-caused by thyroid and cervical surgery
-tracheal intubation
-trauma
-neurodegenreative or muscular disease
presentaiotn of unilateral Vocal cord paralysis 2
voice may be hoarse and breathy
airwya usually not obstructed
presentation of bilateral Vocal cord paralysis
voice is of good quality albeit limited intensity and pitch modulation
however
AIRWAY IS INADEQUATE CAUSING STRIOR AND SOB ON MODERATE EXERTION
management of Vocal cord paralysis unilateral 3
surgical process to move cords closer together
3 options
-augmentaion, medialization, reinnervation
augmentation
-injecting paste of bodily tissue into paralysed cord brining them closer together
medialisation
-shihfitng vocal cord toward sideline by insertinng adjustable speed laterally to affected cord
-done under LA - allow position of spacer to be tuned to patients voice
management of bilateral Vocal cord paralysis 2
surgical procdure and measures to maintain airway
adequate airway must be reestablished
tracheotomy may be needed permanently or temporarily
long term options involve cutting into the glottis to open vocal cords to ensure adequate air entry but can compromise voice
what is the main differnce in management of unilateral vs bilateral Vocal cord paralysis
unilateral- surgery to move cords closer together
bilateral
- surgical procedures and measures to maintain airway
