THROAT – Vocal Cord Palsy

THROAT – Vocal Cord Palsy

Vocal cord palsy commonly gives a rough or husky voice. The Voicebox has 2 vocal cords. When one of the vocal cord is not moving or gets paralyzed it is called Vocal Cord palsy.

Motor Paralysis:
1) Cortical paralysis:
These lesions are rare as the larynx has bilateral motor innervation. May be seen in case of :

●  Congenital cerebral palsy

●   Encephalitis

●   Kernicterus

●   Diffuse cerebral arteriosclerosis

2) Corticobulbar paralysis: These are extremely rare due to paralysis of the corticobulbar tracts.

●  Vascular insufficiencies such as vertebral or posteroinferior cerebellar arteries

●   Multiple sclerosis

●   Intramedullary tumors like gliomas.

4) Peripheral causes: They are responsible for 90 percent of the vocal cord paralysis. The lesion involves the fibres of the laryngeal nerves from the surface of the medulla up to the larynx. Usually combines with multiple cranial nerves.
Peripheral paralysis of the vocal cords is divided into two groups:

●   High vagal paralysis: Lesions near the ganglion with only recurrent laryngeal nerve damage

●   Low vagal paralysis: Nerve intact up to ganglion

Peripheral causes of vocal cord palsy:
Inflammatory

●   Neuritis

●   Meningitis

●   Diphtheria

●   Herpes zoster

●   Tuberculosis

●   Jugular bulb thrombophlebitis.

Neoplastic

●   Meningioma

●   Glomus jugulare

●   Thyroid Malignancy

●   Thymus tumors.

●   Malignant lymphoma

Trauma

●   Blunt neck trauma

●   Bullet wounds

●   Fracture clavicle

●   Surgical trauma

●   Thyroidectomy

●   Tracheostomy

●   Radical neck dissection

●   Pneumonectomy