Laryngeal nerve damage
Vocal cord paralysisLaryngeal nerve damage is injury to one or both of the nerves that cause the voice box to function.
Causes
Injury to the laryngeal nerves is uncommon.
When it does occur, it can be from:
- A complication of neck or chest surgery (especially thyroid, lung, heart surgery, or cervical spine surgery)
- A breathing tube in the windpipe (endotracheal tube)
- A viral infection that affects the nerves
- Tumors in the neck or upper chest, such as thyroid or lung cancer
Thyroid
Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located in the front of your lower neck.
ImageRead Article Now Book Mark ArticleLung cancer
Lung cancer is cancer that starts in the lungs. The lungs are located in the chest. When you breathe, air goes through your nose, down your windpipe...
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- Neck or chest trauma
Symptoms
Symptoms include:
- Difficulty speaking
- Difficulty swallowing
- Hoarseness
Injury to the left and right laryngeal nerves at the same time can cause a breathing problem. This can be an urgent medical problem.
Exams and Tests
The health care provider will check to see how your vocal cords move. Abnormal movement may mean that a laryngeal nerve is injured.
Tests may include:
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Bronchoscopy
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
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CT scan of the chest
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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MRI of the brain, neck, and chest
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
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X-ray
X-ray
X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray waves through the body. The images...
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Treatment
Treatment depends on the cause of the injury. In some cases, no treatment may be needed and the nerve may recover on its own. Voice therapy is useful in some cases.
If surgery is needed, the goal is to change the position of the paralyzed vocal cord to improve the voice. This can be done with:
- Arytenoid adduction (stitches to move the vocal cord toward the middle of the airway)
- Injections of collagen, Gelfoam, or another substance
- Thyroplasty
If both the left and right nerves are damaged, a hole may need to be cut into the windpipe (tracheotomy) right away to allow breathing. This is followed by another surgery at a later date.
Outlook (Prognosis)
The outlook depends on the cause of the injury. In some cases, the nerve rapidly returns to normal. However, sometimes the damage is permanent.
When to Contact a Medical Professional
Contact your provider if you have:
- Difficulty breathing (call right away)
- Unexplained hoarseness that lasts for more than 3 weeks
References
Dexter EU. Perioperative care of the thoracic surgical patient. In: Sellke FW, del Nido PJ, Swanson SJ, eds. Sabiston and Spencer Surgery of the Chest. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 4.
Nouraei SAR, Sandhu GS. Laryngeal and esophageal trauma. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 66.
Woodson G. Pathophysiology of recurrent laryngeal nerve injury. In: Randolph GW, ed. Surgery of the Thyroid and Parathyroid Glands. 3rd ed. Philadelphia, PA: Elsevier; 2021:chap 42.
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Nerves of the larynx - illustration
Laryngeal nerve damage can be caused by injury, tumors, surgery, or infection. Damage to the nerves of the larynx can cause hoarseness, difficulty in swallowing or breathing, or the loss of voice. Treatment depends on the cause and extent of the laryngeal nerve damage.
Nerves of the larynx
illustration
-
Laryngeal nerve damage - illustration
Damage to the laryngeal nerve can result in loss of voice or obstruction to breathing.
Laryngeal nerve damage
illustration
-
Nerves of the larynx - illustration
Laryngeal nerve damage can be caused by injury, tumors, surgery, or infection. Damage to the nerves of the larynx can cause hoarseness, difficulty in swallowing or breathing, or the loss of voice. Treatment depends on the cause and extent of the laryngeal nerve damage.
Nerves of the larynx
illustration
-
Laryngeal nerve damage - illustration
Damage to the laryngeal nerve can result in loss of voice or obstruction to breathing.
Laryngeal nerve damage
illustration
Review Date: 11/29/2022
Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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