Bilateral Vocal Cord Paralysis

What is bilateral vocal cord paralysis?

Bilateral vocal cord paralysis is a term used to describe conditions in which the movement of both vocal cords is restricted. To understand what this definition means, we must first look at how the vocal cords work. Every person has two vocal cords responsible for producing sound and protecting the airway. The vocal cords are located horizontally in the larynx, are connected at the front and can be separated at the back. The movements during breathing and speaking can be likened to the opening and closing of the arms of the letter V. They open when breathing and touch when speaking.

How does bilateral vocal cord paralysis occur?

Bilateral vocal cord paralysis describes conditions in which the movement of both vocal cords is limited. The most common cause of bilateral vocal cord paralysis is surgery in the neck area; the most common cause is thyroid (goitre) surgery. Paralysis of the vocal cords can also occur after some surgeries to treat neck veins or neck hernias. In addition to surgical causes, tumours in the head, neck or chest areas, blunt or sharp trauma affecting the same areas and general anaesthesia through intubation during any surgical procedure can also lead to bilateral vocal cord paralysis.

What are the Symptoms of Bilateral Vocal Cord Paralysis?

The primary complaint of patients is respiratory distress. Respiratory distress increases markedly in exertional situations. Mild or severe voice problems may also be present. Loud breathing or snoring during sleep may also be prominent.

How is bilateral vocal cord paralysis diagnosed?

The disease can be diagnosed by means of flexible fibreoptic laryngoscopy or videolaryngostroboscopy, which allows the vocal cords to be visualised during breathing and phonation and, if possible, can also be video recorded.

How is bilateral vocal cord paralysis treated?

Treatment of the disease aims to reduce respiratory distress. It is essential to separate the vocal cords that are positioned very close to each other. Various treatment methods can be applied for this purpose. These include removing some of the cartilage holding the vocal cords, opening the airway with a laser and changing the position of the vocal cords with sutures.

The attached photograph shows the vocal cords of a patient with bilateral vocal cord paralysis before (left) and after (right) treatment.