Vocal cord paralysis
In adults, vocal cord paralysis may present as dysphonia, hoarseness, dysphagia, and conversational dyspnea. Infants and children may present with weak cry, stridor, cough, hoarseness, and respiratory insufficiency. Neonates can rarely develop vocal cord paralysis secondary to nerve damage during delivery.
Treatment and prognosis for recovery depend on cause and time from onset as some underlying etiologies can recover spontaneously while others are permanent. Bilateral vocal cord paralysis results in stridor and airway compromise. These patients will often require re-intubation and consideration of a surgical tracheostomy for airway safety.
J38.00 – Paralysis of vocal cords and larynx, unspecified
302912005 – Vocal cord palsy
- Viral infection (idiopathic) – Epstein-Barr virus, herpes simplex virus, Lyme disease
- Iatrogenic from thyroid surgery, spine surgery, esophageal surgery, carotid surgery, mediastinal surgery, or neurosurgery due to injury to the recurrent laryngeal nerve
- Iatrogenic from intubation and subsequent nerve compression
- Cerebrovascular injury
- Neurodegenerative disorder – amyotrophic lateral sclerosis, suprabulbar palsy, multisystem atrophy
- Head / neck malignancy with neurologic invasion (see, eg, laryngeal cancer)
- Skull base neoplasm
- Laryngeal trauma (blunt and penetrating)
- Posterior glottic stenosis with vocal cord immobility
- Intubation injury
- Autoimmune vasculitis